Contents of the Template
This template includes:
- Healthcare Professional Information: A section for the healthcare professional’s full name, title, license number, and contact information.
- Patient Information: Fields for patient details including full name, date of birth, address, and phone number.
- Disability Information: Designated areas to outline the specific diagnosis, date of diagnosis, and the impact of the disability on the patient’s daily life.
- Service Animal Information: Sections for detailing the type of animal, the animal’s name (if applicable), and the specific tasks the animal has been trained to perform.
- Letter Body: A structured and formal letter layout that includes a polite request for accommodation under relevant laws.
- Signature Section: A place for the healthcare professional’s signature, reaffirming the authenticity of the letter.
Why Use This Template
- Ease of Use: This template is straightforward and user-friendly, designed to be easily filled out by healthcare professionals.
- Standardized Format: Provides a consistent and organized format that is widely accepted and recognized.
- Time-Saving: Helps in crafting a detailed and effective letter quickly, without the need to start from scratch.
- Customizable: Available in Word and Google Docs, this template can be modified to suit individual needs and preferences.
- Compliance with Regulations: The template is designed to help in drafting a letter that complies with necessary laws and regulations regarding service animals.
Ideal For
- Healthcare Professionals: Doctors, psychologists, and other healthcare providers who are treating patients that require a service animal as part of their treatment plan.
- Patients with Disabilities: Individuals who have a diagnosed disability and need a service animal to assist them in daily life.
- Housing Situations: Use of this template is beneficial when a patient is seeking to live in a residence that typically does not allow pets, as it helps to formally request an exception under the Fair Housing Act.
- Air Travel: For patients who need to travel with their service animal, this template can be used to request accommodation under the Air Carrier Access Act.
- Public Access Cases: When a patient needs to access public facilities or areas where pets are generally not allowed, this letter can help in gaining the necessary permissions and access.
