The question of which doctor can “prescribe” a service dog stems from a common misunderstanding of how these working animals are legally recognized. A service dog is not a piece of medical equipment that a professional writes an order for, like a wheelchair or a prescription drug. Instead, the Americans with Disabilities Act (ADA) defines a service animal as a dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability. The process involves a medical or mental health professional confirming a qualifying disability and the need for the animal’s mitigating tasks, not issuing a prescription for the dog itself.
Establishing the Need: Who Confirms Disability
The first step in acquiring a service dog is establishing that the individual has a disability—a physical or mental impairment that substantially limits one or more major life activities. The ADA requires this underlying condition, but it does not mandate specific documentation for public access. A healthcare professional must ultimately confirm the diagnosis that necessitates the dog’s assistance.
This confirmation comes from a wide range of licensed professionals, depending on the nature of the condition. For physical limitations, a general practitioner (MD or DO) can confirm chronic conditions, or a physical therapist may attest to mobility issues. Neurologists are the appropriate specialists for conditions affecting the nervous system, such as epilepsy or multiple sclerosis, which might require a service dog for stability or seizure response.
For non-physical conditions, the determination involves a licensed mental health provider, such as a psychiatrist, a licensed clinical social worker (LCSW), or a licensed psychologist. Their role is to verify a mental impairment, like Post-Traumatic Stress Disorder (PTSD) or severe anxiety, and confirm that it limits major life functions. This establishes the need for a psychiatric service dog, but these professionals do not officially “prescribe” the dog.
Service Dogs Versus Emotional Support Animals
Much of the confusion around a “prescription” arises from the differences between service dogs and Emotional Support Animals (ESAs). Service dogs are defined by the specific, trained tasks they perform to mitigate a disability and have public access rights under the ADA. Federal law does not require any documentation, letter, or ID card for a service dog in public spaces.
In contrast, an Emotional Support Animal provides comfort simply through its presence and lacks specific task training. ESAs do not have the same public access rights as service dogs. However, ESAs are protected under the Fair Housing Act (FHA), requiring housing providers to make reasonable accommodations, even in “no pets” buildings.
To obtain this housing accommodation, a person needs a letter from a licensed mental health professional. This letter verifies the individual’s mental health disability and the need for the animal as support. This documentation requirement for ESAs is what many people mistakenly refer to as a “prescription” and frequently conflates with the requirements for service dogs.
Medical Requirements for Specific Service Dog Tasks
The type of medical specialist confirming the need is often specific to the task the service dog will be trained to perform. The functional link between the diagnosis and the dog’s tasking legally establishes the animal as a service dog.
Diabetic Alert Dogs
For individuals with Type 1 Diabetes, an endocrinologist or primary care physician confirms the diagnosis of hypoglycemia unawareness. This justifies the need for a diabetic alert dog, which is trained to detect minute drops in blood sugar through scent and alert the handler.
Seizure Response Dogs
A neurologist must confirm the diagnosis and frequency of seizures for a person seeking a seizure response or seizure alert dog. The dog’s task, such as alerting a person to an impending seizure or performing deep pressure therapy, is directly tied to the medical reality confirmed by the specialist.
Psychiatric Service Dogs
For psychiatric service dogs, a mental health provider must confirm the need for specific mitigating tasks. Examples include retrieving medication on command or performing a room search to alleviate paranoia. These tasks must directly address the functional limitations caused by the confirmed disability.
Beyond the Doctor’s Note: The Role of Training and Certification
While medical documentation is necessary to establish the underlying disability, the dog’s training ultimately confers its legal status. The ADA does not require professional training; the handler can train the dog themselves. The dog must be individually trained to perform work or tasks directly related to the handler’s disability.
There is no federal requirement for service dogs to be certified, registered, or to wear a specific vest or harness. Any documentation or ID card obtained is largely for convenience and is not legally mandated for public access. The medical professional’s role is complete once the functional need for the dog’s assistance is established. The subsequent step is intensive, task-specific training and a demonstration of impeccable public access manners.