Online Medical Exam

Compassion Plan

BEST VALUE

ESA Housing Letter!
PSD Travel Letter!
Dogs ONLY
Will NOT Need To Have To Go Through The Approval Process Again!
Significant Annual Discounted Rate!
Whether You Own Your Home, or Never Travel With Your Pet, This Is The BEST & CHEAPEST PLAN!

$199

Covers 1 Animal (Additional Animals Can Be Added)
* ESA/ PSD ID Card and/ or Hard Copy Letters Are Also Available!

ESA Housing Plan

ESA Housing Letter ONLY
Must Pay FULL Price To Renew
Does NOT Include PSD Travel Letter
Letter Never Expires, Unless You Move
Exempt From Pet Rent & Pet Deposit!

$159

Covers 1 Animal (Additional Animals Can Be Added)
* ESA ID Card and/ or Hard Copy Letter Is Also Available!

PSD Travel Plan

PSD Travel Letter ONLY
Dogs ONLY
Covers ALL Domestic & International Flights Originating in the US or Run by US Airlines
Except AeroMexico – They Will NOT Accept This Letter
Covers ALL Flights For 1 Year From Date of Issue!
EXEMPT From ALL Airline Fees!
MUST Pay FULL Price To Renew
Does NOT Include ESA Housing Letter

$149

Covers 1 Dog (Additional Dogs Can Be Added)
* PSD ID Card and/ or Hard Copy Letter Is Also Available!

Choose a Plan:*

Compassion Plan - $199 (Covers 1 Pet Only)
Care Plan - $159 (Covers 1 Pet Only)
Travel Plan - $149 (Covers 1 Pet Only)

Additional Pets

Do you have or want more than 1 pet as an ESA? Get a discount of ONLY $99 for each additional pet!

ID Card Sample

ESA ID Card and Lettter Mailed via USPS?*

* We will email you an ESA PDF letter regardless of what option is selected. The Hardcopy of the ESA letter is printed on special 67lb weighted paper and should be used when traveling overseas.

USPS Shipping Options*

USPS Standard
USPS PRIORITY w/Tracking

Pet Name*

Pet Breed*

Please enter breed like this, "terrier" or "terrier/poodle" and leave out american or any other additional info like "american" or words "with" etc.

Pet Weight (lbs)*

Pet Image*

Accepted file types: jpg, jpeg, png, Max. file size: 2 MB.

If your image is too big, please visit the following website - https://www.iloveimg.com/resize-image , upload your image, then set the 'width' to 300, press RESIZE and download the smaller image

Pet #2 Name*

Pet #2 Breed*

Pet #2 Weight (lbs)*

Pet #2 Image

Accepted file types: jpg, jpeg, png, Max. file size: 2 MB.

Pet #3 Name*

Pet #3 Breed*

Pet #3 Weight (lbs)*

Pet #3 Image*

Accepted file types: jpg, jpeg, png, Max. file size: 2 MB.

Would you like a hard copy of your letter sent via USPS?*

ESA Letter via USPS Standard +$10.00
ESA Letter via USPS PRIORITY w/Tracking +$20.00
No Hard Copy

Optional Same Day Service

Same Day Rush Service

Do you want or need this approval process expedited to ensure that you get your approval letter within 24 hours if you are approved? Get your submission to the top for a rush fee of ONLY $49.95!

Rush Service Deadline*

12 hours +$69.95
24 hours +$49.95

Total

$0.00

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Very Important: Make sure that the address and zip code entered below match with what the Credit Card you are using has on file. If it does not match, the payment will not get approved and you will have to start the entire process over from the beginning.

Credit Card*

Card Details

Cardholder Name

Coupon

Required*

BY CHECKING THIS BOX, AND UNDER THE PENALTY OF PERJURY, I ACKNOWLEDGE THAT I HAVE ANSWERED THE QUESTIONS ON THIS MEDICAL QUESTIONNAIRE COMPLETELY HONEST AND TRUTHFUL REGARDING MY EMOTIONAL/ MENTAL HEALTH AND THE NEED TO HAVE AN ESA(s)/ PSD(s) TO IMPROVE MY HEALTH AND OVERALL WELL-BEING.

BY CHECKING THIS BOX, I UNDERSTAND THAT I AM GIVING MY CONSENT FOR THE DOGTOR TO SUBMIT MY MEDICAL QUESTIONNAIRE TO AN INDEPENDENT LICENSED MEDICAL PROFESSIONAL IN THE DOGTOR’S MEDICAL REFERRAL NETWORK TO REVIEW AND EVALUATE MY QUESTIONNAIRE.

BY CHECKING THIS BOX, I UNDERSTAND THAT IF I AM APPROVED FOR AN EMOTIONAL SUPPORT ANIMAL(s) AND/ OR PSYCHIATRIC SERVICE DOG(s), MY ESA IS ONLY CONSIDERED AN “ESA” FOR HOUSING PURPOSES, AND/ OR MY PSD IS ONLY CONSIDERED A “PSD” FOR FLYING, ACCORDING TO THE DEPARTMENT OF TRANSPORTATION.

BY CHECKING THIS BOX, I UNDERSTAND IF I AM APPROVED FOR AN EMOTIONAL SUPPORT ANIMAL(s) AND/ OR PSYCHIATRIC SERVICE DOG(s) BY THE DOGTOR, I WILL NOT BE ENTITLED TO A REFUND FOR ANY REASON. SHOULD I CHOOSE TO CANCEL AND ASK FOR A REFUND PRIOR TO RECEIVING MY APPROVAL LETTERS FROM THE DOGTOR, I WILL BE CHARGED A $50 CANCELLATION FEE.

BY CHECKING THIS BOX, I UNDERSTAND THAT SHOULD I BE APPROVED BY THE DOGTOR FOR AN ESA AND/ OR PSD LETTER, ALTERING ANY PART OF THE LETTER(S) I RECEIVE, COULD BE CONSIDERED A CRIME, AND I WILL BE HELD RESPONSIBLE FOR THE APPLICABLE PUNISHMENT PERTAINING TO STATE AND/ OR FEDERAL LAWS

BY CHECKING THIS BOX, I UNDERSTAND THAT DUE TO THE RECENT CHANGES IN CALIFORNIA AND LIVING IN THE STATE OF CALIFORNIA, I WILL NOT RECEIVE MY “PERMANENT” ESA LETTER, FOR HOUSING PURPOSES, UNTIL 30 DAYS AFTER MY MEDICAL APPROVAL. (However, You WILL Receive a “TEMPORARY” ESA Housing Letter & Your PSD Travel Letter IMMEDIATELY). * This ONLY Pertains To California Residents ONLY. * If You Do NOT Live In California, Please Check The Box To Continue, But Know That This Box Does NOT Apply To You.

BY CHECKING THIS BOX, AND LIVING IN THE STATE OF CALIFORNIA, I UNDERSTAND THAT: KNOWINGLY AND FRAUDULENTLY REPRESENTING ONSELF TO BE THE OWNER OR TRAINER OF ANY DOG LICENSED AS, TO BE QUALIFIED AS, OR IDENTIFIED AS, A GUIDE, SIGNAL, OR SERVICE DOG IS A MISDEMEANOR. * This ONLY Pertains To California Residents ONLY. * If You Do NOT Live In California, Please Check The Box To Continue, But Know That This Box Does NOT Apply To You.

Attention: You must submit payment in order for this medical exam to be evaluated.

Online Exam Form

Step 1 of 8

Part I: Personal Information

Section 2: General and Mental Health

Section 3: General Medical History:

Section 4: Major Depression

Section 5: Generalized Anxiety & Panic Disorder

Section 6: Post Traumatic Stress Disorder

Section 7: SOCIAL PHOBIAS