Application Form | Emotional Support Animal Letter
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Section 1: Your Details

Full Name
Your medical letter will be sent to this email address
Date of Birth
Address

Section 2: Purpose of ESA Letter

Please provide details about who or what you need this letter for, so we can customise it to suit your specific needs. If your purpose doesn't fit any of the listed categories, simply select 'Other'.

Please select from the following (you can select more than one option):

Section 3: Medical Information

Please provide as much detail as possible

Section 4: Your Emotional Support Animal

Do you already have your emotional support animal?

Section 5: Identity Verification

Click or drag files to this area to upload. You can upload up to 100 files.

Section 6: Anything Else? (Optional)

Click or drag files to this area to upload. You can upload up to 100 files.

Terms and Conditions

By submitting your application, you confirm your understanding of our Terms and Privacy Policy, and agree to the following:

  1. You confirm that you have carefully understood all the questions in the application and have answered them truthfully.
  2. The letter requested is issued solely for the individual whose name and details have been provided, and cannot be used for anyone else.
  3. Our letters are provided to confirm your need for an emotional support animal. They do not serve as insurance, medical consultation, or any form of legal protection against adverse events.
  4. Wilmer Health does not provide any medical consultation or treatment. We are not liable for any negative outcomes related to the use of the letter at any time.
  5. Neither Wilmer Health nor our doctors accept liability for any consequences that may affect third parties you present this letter to.
  6. If your letter is not accepted by a third party, such as an employer or landlord, Wilmer Health and our doctors cannot be held responsible for any associated costs.
  7. You confirm that all evidence submitted is accurate and that you have not deliberately omitted any relevant information.
  8. Once our doctor has reviewed your application and provided a letter, refunds cannot be processed.
  9. Wilmer Health does not replace your primary care doctor. Our healthcare professionals do not have access to your medical records.
Agreement to Terms and Conditions

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Price: £45.00