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Center for Academic Success and Accessibility Services Southern Connecticut State University New Haven, Connecticut 06515HOUSING ACCOMMODATION/ASSISTANCE ANIMAL LICENSED PROFESSIONAL FORM Students
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How to fill out emotional-support-animal-request-professional-provider-form

01
Obtain the emotional support animal request professional provider form from a qualified mental health professional.
02
Fill out the form completely including your personal information, such as name, address, and contact information.
03
Provide detailed information about your emotional support animal, including its breed, age, and the specific tasks it is trained to perform.
04
Have the mental health professional sign and date the form to certify that you have a mental or emotional disability that requires the use of an emotional support animal.

Who needs emotional-support-animal-request-professional-provider-form?

01
Individuals who have a mental or emotional disability and require the use of an emotional support animal to help alleviate symptoms of their disability.
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The emotional-support-animal-request-professional-provider-form is a form used to request approval for an emotional support animal from a professional provider.
Individuals seeking approval for an emotional support animal are required to file the emotional-support-animal-request-professional-provider-form.
The form should be completed with accurate information about the individual's need for an emotional support animal and signed by a qualified professional provider.
The purpose of the form is to document the need for an emotional support animal and obtain approval from a professional provider.
The form should include information about the individual's disability, the benefits of having an emotional support animal, and the professional provider’s recommendation.
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