There is a growing trend of individuals requesting emotional support animal (ESA) “letters” from licensed mental health professionals. However, no current standards exist for making these evaluations. The current study sought to examine, within a specific sample, (1) roughly how many and what type of mental health professionals are making ESA evaluations and (2) to explore what instruments these practitioners used, or would use, for making such an evaluation. Through the use of a sample of 87 mental health professionals, 31.4% of whom have actually made ESA recommendations, the current study demonstrates that both clinical and forensic practitioners within the current sample are making ESA recommendations and believe it is appropriate for treating mental health professional to offer an opinion on the need for an ESA. This demonstrates that neither group in the current sample recognizes the potential role conflicts this presents when one mixes forensic and clinical functions. Further, results of the survey revealed that forensic practitioners were significantly more likely to choose more complex and forensically valid assessment instruments (e.g., malingering assessment) for ESA evaluations when compared with clinical practitioners. We conclude with a set of recommendations for practitioners to choose to conduct ESA evaluations.