Clinical Screening for ESA & PSD Letters
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Clinical Evaluation v3.6
Step 1/16
Evaluation Type
What type of documentation do you need?
Housing (ESA)Waive Pet Fees
→
Travel (PSD)Flights + Housing
→
Support Companion
🐶Dog
🐱Cat
🐰Rabbit
🦜Bird
🐹Small Pet
🐾Other
Jurisdiction
↓
In the past 2 weeks, how often have you felt nervous or on edge?
Never / No
→
Sometimes
→
Often / Yes
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Not being able to stop or control worrying?
Never / No
→
Sometimes
→
Often / Yes
→
Worrying too much about different things?
Never / No
→
Sometimes
→
Often / Yes
→
Little interest or pleasure in doing things?
Never / No
→
Sometimes
→
Often / Yes
→
Feeling down, depressed, or hopeless?
Never / No
→
Sometimes
→
Often / Yes
→
Trouble falling or staying asleep?
Never / No
→
Sometimes
→
Often / Yes
→
Feeling tired or having little energy?
Never / No
→
Sometimes
→
Often / Yes
→
Poor appetite or overeating?
Never / No
→
Sometimes
→
Often / Yes
→
Trouble concentrating on things?
Never / No
→
Sometimes
→
Often / Yes
→
Do you avoid social situations due to anxiety?
Never / No
→
Sometimes
→
Often / Yes
→
Do symptoms limit daily life activities?
Never / No
→
Sometimes
→
Often / Yes
→
Does your animal mitigate these symptoms?
Never / No
→
Sometimes
→
Often / Yes
→
Analysis Complete
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