GMC-Registered Doctors

Emotional Support Animal (ESA) Letter

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Who is this letter for?

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We just need to know if you’re filling this in for yourself or on behalf of someone else.

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Myself Someone Else (e.g. parent / guardian)

Please select an option

Your Name * As the person completing this form on their behalf.

Your name is required

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About the patient

The name below will appear exactly as entered on your ESA letter.

First Name *

First name is required

Last Name *

Last name is required

Date of Birth *

Valid date of birth required

Phone Number * In case our doctors need to clarify your details. We won't call without reason.

Please enter a phone number

Sex *

Please select your sex

Where should we send your letter?

Your ESA letter will be delivered to this email address. Please double-check it before continuing.

Email Address *

Please enter a valid email address

📧 Check your spam folder If you don’t receive your letter by 9am next day, please check your spam or junk folder.

Your emotional support animal

Tell us about your emotional support animal. Up to 2 pets can be named per letter.

Pet Type *

🐶 Dog 🐱 Cat Other

Please select your pet type

Pet’s Name * As you’d like it to appear on the letter.

Pet name is required

Pet Photo (optional — used on digital photo-card if ordered)

🐾

Upload a clear photo of your pet

Browse files

Do you need to add a second pet? (up to 2 per letter)

Please answer this question

Most letters cover one pet. Select 'No' to skip the second pet step.

Second emotional support animal

Tell us about your second emotional support animal.

Pet Type *

🐶 Dog 🐱 Cat Other

Please select your pet type

Second Pet’s Name * As you’d like it to appear on the letter.

Pet name is required

Second Pet Photo (optional)

🐾

Upload a clear photo of your second pet

Browse files

Your condition

Select all conditions that apply. This helps our doctors tailor your letter accurately.

Which condition(s) do you require a support animal for? *

Anxiety Depression Post Traumatic Stress Disorder (PTSD) Autism Spectrum Disorders (ASD) Personality Disorders Schizophrenia Phobia Learning Disability Other

Please select at least one condition

How your animal helps you

Describe your condition * Tell us: how long you've had the condition, how it affects your daily life, and specifically how your animal helps you.

Please describe your symptoms

Medical background

Almost done. These details help our doctors provide the most accurate letter.

Do you have any underlying health issues or past medical history? *

Please answer this question

Please list your underlying health issues or past medical history

Do you take any regular medication? * Including both prescribed and over-the-counter medication.

Please answer this question

Please list your regular medications

Verification documents

Medical Documentation GP record, NHS app screenshot, or similar.

No formal diagnosis? If you suffer from anxiety or depression but do not have a formal diagnosis, please click here to complete the diagnostic questionnaire.

✓ Questionnaire completed — results will be sent with your submission.

🩺

Tap to select files, or drag & drop

Browse files

Short Video (optional) Describing how your animal supports you.

🎥

Tap to select a video, or drag & drop

Browse files

Photo ID Driver’s licence, passport, or residence permit.

🪪

Tap to select your ID photo

Browse files

⚠️

Documents not on this device? No problem — you can email them from your computer after completing this form. Send your files to [email protected] with your submission reference as the subject line. You'll receive your reference on the confirmation screen.

I will send the files via email to [email protected] instead of uploading now. (Please note, our doctors will start on your case once we have received your documents.)

Diagnostic Questionnaire

These are standard clinical screening tools. Your answers are confidential and reviewed only by your doctor. They help us provide more personalised care.

⚠️ Please answer all questions before continuing.

Please check everything is correct before submission.

✏️ Not sure about something? Tap any section below to go back and edit.

View full terms and consent details

I agree that upon submitting my medical consultation, I acknowledge the Terms and Privacy Policy and consent to the following: I am NOT seriously unwell with any of the following symptoms: chest pain, shortness of breath, unrelenting severe headache, worsening severe abdominal pain, loss of vision, thoughts of suicide, confusion, ongoing bleeding, unable to swallow fluids or saliva, loss of limb sensation or control, facial numbness or weakness, slurred speech. I understand the questions in the questionnaire and answered them honestly. The requested letter is solely for the individual with the provided name and details. Medical Cert is not a replacement for a doctor’s visit. I confirm I do not think I need to see a medical professional in person. Medical Cert is not my primary doctor or GP, and the doctor issuing my certificate may be unable to access my NHS or regular GP medical records. Medical Cert facilitates access to private medical letters and does not issue Med3 notes, which are obtainable through your NHS GP for UK government benefits. Medical Cert is unable to process refunds once a medical letter has been written and sent to you. If my symptoms persist or I have not fully recovered, I agree to consult with my regular doctor or GP for further medical advice. I consent to having this website store my submitted information so they can respond to my inquiry.

I have read and agree to the Terms and Privacy Policy, and confirm all my answers are accurate and truthful.

You must agree to the terms to continue

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📱

Add Digital Photo-Card +£10

Confirms your ESA on-the-go on your phone — click to add for £10.

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Emotional Support Animal (ESA) Letter

Who is this letter for?

About the patient

Where should we send your letter?

Your emotional support animal

Second emotional support animal

Your condition

How your animal helps you

Medical background

Verification documents

Diagnostic Questionnaire

Complete Your Order

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