Step 1 of 7 14% About YouName*Email*Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Living SituationI have the following type of rental agreement:*Written contract with a month to month termWritten contract with a year termOral agreementNot sureCurrent living situation:*Living at the propertyNot living at the propertyThe status of my case is:*A lawsuit has been filedNotices to vacate have been mailed or postedDemands have been madeNothing has happened yetI don't knowMy case issue(s) are:*Unjustified evictionBreach of a lease provisionOtherOther* Clinician/Physician (Clinical Provider)Did you purchase an Emotional Support Animal (ESA) letter from an online vendor?*YesNoWere 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?*YesNoIs your Clinical Provider licensed and located in your state of residence?*YesNoI don't knowIs your Assistance Animal either a dog, cat, or bird?*YesNoDid your Clinical Provider supply an ESA letter verifying the need for an Assistance Animal within the past 12 months?*YesNoDoes your ESA letter confidently state that you are a patient of a Clinical Provider, or would confidently state your Clinical Provider has diagnosed you with a physical/mental/psychological disability?*YesNoI don't knowDo you receive Social Security Disability Income or VA income?*YesNo Reasonable Accommodation RequestDo you have written proof of providing your ESA letter to the Housing Provider?*YesNoWritten proof can be email, fax, text message, or tracking number for mail delivery.Do you have written proof of requesting an accommodation from the Housing Provider?*YesNoDo you have written proof of being denied the accommodation you requested?*YesNoHave you been denied due to the Housing Provider’s no-pets-allowed rule?*YesNoHave you been denied due to the Housing Provider’s breed, weight, or size restrictions?*YesNoDo you have possession of any written rules, regulations, policies, or procedures which you think might be discriminatory?*YesNoDid your Housing Provider accidentally discover your Assistance Animal?*YesNoIs your Assistance Animal accused of biting, nipping, lunging at any person, or being aggressive?*YesNo Housing ProviderDid the alleged discriminatory act happen within the last 365 days?*YesNoDid the alleged housing discrimination occur at a hotel, motel, RV park or any other temporary housing?*YesNoDo you rent a room from your landlord and your landlord lives in the same unit/house/condo?*YesNoI don't knowDo you have at least one fine/notice for not cleaning up after your Assistance Animal?*YesNoDo you have at least one fine/notice which accuses your Assistance Animal of being a nuisance for excessive barking etc.?*YesNoAre you behind on your rent, or have you refused to pay rent, or behind on fines & penalties to the property?*YesNoDo you rent a unit from a small landlord who rents a total number of four units or less?*YesNoI don't know Case Detail (300 words or less)Describe your case in detail: (300 words or less)* Contact PreferencesRelease your contact info to interested lawyers in our network?*YesNoBy 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. * This free service is not yet available in all 50 states.
