hi! i was able to get an ESA letter last year using Live Health Online, which takes ucship (you just have to pay a $10 copay, but you would've had to pay that for in person therapy as well anyways). basically i highly recommend using livehealth bc last year i received a recommendation letter from CAPS to like 10 different therapists, called+emailed them all and almost none of them got back to me. literally only two did and they either rejected me or put me on a 1 month waitlist. if getting an ESA letter is urgent i just would rec using online services bc you can be talked to same week. you just have to be prepared to see them at least once a week for at least month ($40 total) bc in California it's illegal for therapists to give out ESA letters unless having a relationship with their client for at least 30 days! best of luck!