"(Name of patient) is my patient and I have diagnosed her with (name of illness/disability), which limits her major life activities of (include all that apply: walking, seeing, hearing, speaking, learning, breathing, performing manual tasks, washing, dressing, socializing, working, or other). I have prescribed emotional support animals to alleviate her problems of (isolation, loneliness, depression, stress, anxiety, or whatever is appropriate) resulting from these limitations and to assist (name of patient) in coping with her (illness/disability)."

Adapted from "Best Friends for Life: Your Right to Animals in No Pet Housing," a brochure published by the Doris Day Animal League.