Additional update for US citizens and potentially anyone in the process of obtaining a letter from an embassy.
I stood outside all day at Phuket Immigration today. I was offered only a 7 day extension despite having a flight booked but when I mentioned I had a letter I was asked to go upstairs (thus voiding my spot after 4 hours in line).
In addition to being denied with the generic email from the US Embassy, Phuket Immigration now requires an ORIGINAL copy of the letter. I asked the officer very specifically if this meant inclusion of one's name and passport number. He told me no. They want letters postmarked from the embassy. He said once I get in contact with my embassy, a letter can arrive in two days. I explained by that point I would be overstaying. He told me to go back downstairs and wait in line AGAIN for an extension. I went down and saw the queue and knew there was zero chance of me getting back in before closing.
I have already emailed the US embassy for a personal emailed letter. I am not sure if a colored version with my info will pass inspection. I also included my letter to the embassy an image of Phuket's Original document requirement.
Additionally, I have a Brazilian friend who's school notified her of the same new regulations. She was told by the Brazilian embassy that they will not postmark any letters and if Phuket Immigration requests this, she will need to pick it up from the embassy reception in Bangkok on Friday from 9am-12pm or have a friend mail it.
Here's an image of the sign that was outside at immigration.
TLDR : Answer Summary
Phuket Immigration has recently updated their requirements for US citizens seeking visa extensions. Applicants now need an original letter from their embassy, postmarked, which has led to complications for those waiting for documentation. Even if a flight is booked, extensions may be limited to just 7 days unless the correct paperwork is presented. This applies similarly to other nationals, as other embassies are implementing similar protocols.