Housing (ESA) Pre-Qualify.

v 7.01, updated June 2021

Caring for oneself.

Showering, toileting, brushing teeth, general body/health maintenance, etc.

1. How big of a problem?*

1. How often does it occur?*

1. How much does the animal help?*

Focus.

Loss of focus due to anxiety/trauma, etc.

2. How big of a problem?*

2. How often does it occur?*

2. How much does the animal help?*

Concentration.

Loss of concentration due to anxiety/trauma, etc.

3. How big of a problem?*

3. How often does it occur?*

3. How much does the animal help?*

Interaction.

Interact with others outside the home to accomplish daily tasks/chores, etc.

4. How big of a problem?*

4. How often does it occur?*

4. How much does the animal help?*

Sleep.

Inability to sleep as well as sleep interrupted by nightmares due to PTSD, etc.

5. How big of a problem?*

5. How often does it occur?*

5. How much does the animal help?*

Disabilities.

Do you receive disability benefits?*

Is your disability known or visible?*

Suicide and self-harm.

Over the past two weeks, have you had thoughts of suicide?*

Yes

Today, have you had thoughts of suicide?*

Yes

Today, did your thoughts include a plan or intent to commit suicide?*

Yes

You’ve indicated that you may be suicidal.

You are important to us, and we want to provide you with the best support we can.

Based on your responses, you are not a candidate for an Emotional Support Animal at this time.

We know from experience that when someone is experiencing this level of distress, an Emotional Support Animal may not be the most appropriate solution.

We advise you to please use the following resources now:

Call the National Suicide Prevention Lifeline

No matter what problems you are dealing with, the National Suicide Prevention Lifeline wants to help you find a reason to keep living.

By calling 1-800-273-TALK (8255) you’ll be connected to a skilled, trained counselor at a crisis center in your area, anytime 24/7.

Talk With Lifeline Crisis Chat

Anyone who is depressed, despairing, going through a hard time, or just needs to talk, including people who are thinking about suicide should click here to get instant access to the National Suicide Prevention Lifeline Crisis Chat.

Help is available 24/7.

Get Help Now

Call 911 or head to your nearest emergency room so that you can be assessed for the level of care that best supports your needs.

Your Life is Precious.
Please Call the Number Below.
1-800-273-TALK

Do you have a therapist or doctor?

Be sure to reach out to them immediately. However, we also suggest that you seek emergency support as listed above.

Ayuda en Espanol

Si está usted preocupado por una persona que usted sabe que está pasando por una crisis o que piensa en suicidarse, nuestros centros pueden ayudarle.

Cuando usted llama al número 1-888-628-9454, su llamada se dirige al centro de ayuda de nuestra red disponible más cercano.

Let’s be honest. Right about now you might be feeling frustrated. After all, you’re in distress and may be in need of emotional support more than ever.

So why are we encouraging you to seek help elsewhere?

Our screening process is designed to make sure that we identify clients we can best help. Experience tells us that seeking care in your local community is the best option.

Therapists in our network cannot fully assess and treat people actively struggling with suicidal thoughts, plans or intent.

By assigning you to a therapist in our network, we are keeping you from getting the help you truly need.

An in-person assessment team can do a much better job determining a specific plan of care for you. This may or may not include an Emotional Support Animal.

We thank you for connecting with us and hope to be able to support you in the future once a plan of care and support team is in place.

How This Works.

The following informational assessment applies to U.S. residents only.

An emotional support animal is a type of assistance animal that is recognized as a “reasonable accommodation” for a person with a disability under the U.S. Fair Housing Act, and is a companion animal that provides therapeutic benefit to an individual with a mental or psychiatric disability.

Taking the informational exam:

Complete the exam above.
For each section, when appropriate select the intensity, how often it happens, and how well the animal helps to ameliorate the issue.

Individuals Seeking an ESA.

Applies to U.S. residents only.
Must have a “disability and disability-related need for an assistance animal” that can be verified.
Has an animal (animals commonly kept in households) that relieves the symptoms of the disability and its effect on major life activities.

Notes:

We respect your privacy and do not tolerate spam and will never sell, rent, lease or give away your information (name, address, email, etc.) to any third party.
Read more about our terms of service and privacy policy.
Our screening tests and psychological self-tests are intended for educational purposes only and should not be understood to constitute a diagnosis or healthcare recommendation. Nor do the results guarantee a particular outcome.
If required, please consult with a mental health professional as soon as possible.
Due to the programmatic nature of these tests, scoring errors can and may occur.