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Are you a Florida resident?*

EC-1-1: We are currently in beta-testing and only offer services to residents of Florida.

Were you denied a request for an Emotional Support Animal reasonable accommodation?*

EC-1-2: At this time, we are only accepting new cases that involve Emotional Support Animal fair housing discrimination.

About You

Address*
Do you live in university or on-campus housing?*
Do you receive Social Security Disability Income (SSDI) or VA income?*

Case Detail

The status of my case is:*
My case issue is:*
Did the alleged ESA housing discrimination happen within the last 365 days?*

EC-3-1: The alleged discrimination must have occurred within the last year. At this time, we cannot assist you.

Did the alleged ESA housing discrimination occur at a hotel, motel, RV park, or any other type of temporary housing?*

EC-3-2: Temporary shelters are not governed by the Fair Housing Act. At this time, we cannot assist you.

Living Situation

I have the following type of rental agreement:*
Current living situation:*
Did you receive a notice of eviction?*
Current on rent?*
Currently owe any fines or penalties?*

FHA Exemptions

Is your residence an owner-occupied buildings with four or fewer units?*

EC-4-1: This living arrangement is not governed by the Fair Housing Act. At this time, we cannot assist you.

Is your residence operated by a religious organization or private club that limits occupancy to members?*

EC-4-2: This living arrangement is not governed by the Fair Housing Act. At this time, we cannot assist you.

Do you live in a single-family homes rented without a broker?*
The FHA doesn't apply when a single-family house is sold or rented without a broker, so long as the owner doesn't own more than three houses.

EC-4-3: This living arrangement is not governed by the Fair Housing Act. At this time, we cannot assist you.

Do you live in senior housing?*
The FHA includes "familial status" as one of its seven protected classes, which refers to the presence of at least one child under 18 living in a household. However, although the FHA bans discrimination against families with children, you may be exempt from this ban if your property qualifies as senior housing. Exempt properties include those that fit the rules of 55 and older or 62 and older communities, or those that participate in a federal, state or local senior housing program.

EC-4-4: This living arrangement is not governed by the Fair Housing Act. At this time, we cannot assist you.

Do you meet the qualifying standards the landlord or housing provider has for all tenants, such as having an income that is two and a half times the monthly rent?*

EC-4-5: This living arrangement is not governed by the Fair Housing Act. At this time, we cannot assist you.

Clinician/Physician (Clinical Provider)

Is your Clinical Provider licensed and located in your state of residence?*
How many therapeutic care sessions did you have within the last 12 months with this Clinical Provider?*
Do you have an ongoing treating relationship with this Clinical Provider?*
Did your landlord or housing provider communicate with your Clinicial Provider without your written permission?*
Did your landlord or housing provider ask details about your disability?*

Emotional Support Animal (ESA) Letter

Do you have an ESA letter verifying the need for an Emotional Support Animal?*
Does your ESA letter state that you are a patient of the above Clinical Provider?*
Does your ESA letter document your disability and disability-related need for an Emotional Support Animal?*
Was your ESA letter issued within the past 12 months?*
Did you purchase your ESA letter from an online vendor?*
Were you required to pay for any of the following: additional pet insurance, training, ESA or Service Animal Registration for a certificate, or service animal vest?*
Accepted file types: jpg, gif, png, doc, docx, pdf, Max. file size: 10 MB.

HIPAA Compliance.

We are a covered HIPAA entity, meaning we take extraordinary measures to guard your Protected Health Information. However, Attorney Members are not bound by these stringent guidelines.

It is important for our Attorney Members to review your documentation, as all successful discrimination claims begin with a "perfect ESA letter." And after issuing countless letters and reviewing a wide variety of client letters, not all documents are "valid."

Sharing your ESA letter of recommendation to Attorney Members requires a signed written waiver, and without both the letter and waiver, we cannot provide your case file to our Attorney Members.

Please review our disclaimer and User Agreement.

Reasonable Accommodation Request

Do you have written proof of submitting your ESA letter to your landlord or housing provider?*
Written proof can be an email, fax, text message, tracking receipt, etc.
Did your landlord or housing provider charge pet fees or require a security deposit?*
Do you have written proof of your accommodation request?*
Has your accommodation request been denied?*
Do you have written proof of being denied your accommodation request?*
Was your accommodation request denied due to a no-pets-allowed rule?*
Was your accommodation request denied due to breed, weight, or size restrictions?*
Do you have a copy of any written rules, regulations, policies, or procedures of your landlord or housing provider which you think might be discriminatory?*
Drop files here or
Accepted file types: jpg, gif, png, doc, docx, pdf, Max. file size: 10 MB.

    Emotional Support Animal

    How many Emotional Support Animals do you have?*
    Do you live in a city or county that has a ban on certain breeds of dogs?*
    Did your landlord or housing provider require specialized training for your Emotional Support Animal?*
    When you signed your lease, did you have a pet or Emotional Support Animal?*
    Did you disclose your animal(s) at lease signing?*
    HUD considers hiding the animal's existence from your landlord at the time of lease signing fraud.
    Did your landlord or housing provider accidentally discover your Emotional Support Animal?*
    Did your fail to notify your landlord or housing provider about your Emotional Support Animal?*

    Warnings, Fines, and Notices

    Has your Emotional Support Animal been accused of biting, nipping, lunging at any person, or being aggressive?*
    Has your Emotional Support Animal been accused of causing damage?*
    Have your been warned or noticed that your Emotional Support Animal is being a nuisance?*
    Have you been fined for your Emotional Support Animal being a nuisance?*

    Contact Preferences

    Do you give us authorization to release your contact information and answers provided on this form to interested lawyers in our network?*
    By submitting your information, you acknowledge that you have read our disclaimer, User Agreement, and consent to receive email and/or SMS messaging communication from ESAD Int'l.

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