Sample Letter from Health Care Provider (Your provider may want to use for
To Whom It May Concern:
[PATIENT’S NAME] is my patient and has been under my care since [DATE].
She/he has a disability as defined by the federal Fair Housing Act and/or the Maine
Human Rights Act. I am intimately familiar with his/her history and with the
functional limitations imposed by his/her disability.
This disability causes these effects: [LIST SYMPTOMS] which would be
mitigated by a service animal. I am therefore prescribing a service animal that
[PATIENT’S NAME] needs to enhance his/her ability to live independently and
that [PATIENT’S NAME] needs to allow him/her an equal opportunity to use and
enjoy his/her dwelling.
[HEALTH CARE PROVIDER/LICENSED SOCIAL WORKER]