Contents of the Template
This template includes:
- Doctor and Patient Information: Clearly marked sections for the healthcare professional’s and patient’s contact and identification details, ensuring all parties involved are properly identified.
- Diagnosis Information: A dedicated section to outline the patient’s specific medical condition, along with the date of diagnosis.
- Impact of Condition: Space to describe how the patient’s condition affects their day-to-day life, illustrating the need for a service animal.
- Recommended Accommodation: A section where the healthcare professional can explicitly state the recommendation for a service animal as part of the patient’s treatment plan.
- Service Animal Details: A table to provide specific information about the service animal, such as name, breed, weight, and age.
- Legal Framework Reference: A section to cite relevant laws and regulations, emphasizing the legal basis for the service animal accommodation.
- Doctor’s Affirmation and Signature: A closing section where the doctor confirms the authenticity of the information and signs the document.
Why Use This Template
- Ease of Use: This template is straightforward and user-friendly, requiring minimal effort to complete.
- Clarity: It is organized and clear, helping to avoid misunderstandings between the patient, doctor, and any third parties.
- Professional Format: The template presents information in a professional and organized manner, which can help when submitting the document as part of a formal request.
- Accessibility: Available in Word, PDF, and Google Docs formats, it can be accessed and edited using various software applications.
- Time-saving: Using this template can significantly reduce the time and effort it takes to draft a letter from scratch.
- Housing Accommodations: When a patient needs to request an exception to a “no pets” policy in housing due to a service animal.
- Air Travel: To provide necessary documentation when a patient requires their service animal to accompany them on a flight.
- Workplace Accommodations: When an employee needs a service animal at their place of work and must provide documentation to their employer.
- Public Access Cases: For instances where a patient needs to affirm the legitimacy of their service animal to access public spaces where pets are typically not allowed.
- Educational Settings: When a student requires a service animal to accompany them in a school or other educational environment.