Licensed Medical Professional Note

This is only an example, your physician may require or prefer something else.

 

Printed on an official medical organization's letterhead

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"To whom it may concern:

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This letter is to confirm that [insert your name] is a patient  who has been seen at [insert clinic or organization name] and has been diagnosed with a disability as defined by the ADA, the FHA, the ACAA, and the Rehabilitation Act of 1973. A service dog is medically necessary to assist them in the treatment of their disability.

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Best regards,

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[Insert licensed medical professional's name]"