​​​​​​        Shadow's Retreat

Downloading this form does not automatically make a reservation.  You must call us at 703-327-6454 to make/confirm this reservation.


                       BOARDING INFORMATION

     OWNER                            Last Name ____________________________________ First Name __________________________________
     OWNER ADDRESS         Street____________________________________________________________________________________
                                               City ____________________________________ State _______________________ Zip _________________
     PHONE NUMBERS          Home _______________________ Cell _____________________________Office_______________________
     EMAIL ADDRESS              _________________________________________________________________________________________
     EMERGENCY                   Contact _______________________________________________ Phone _____________________________
     PET INFORMATION         Name ___________________________    Breed ____________________________________ Age _________
                                               Weight ________ Color ______________________   DOB: __________   Sex: ___Spayed/Neutered circle one
     VETERINARIAN   INFO    Name _______________________________________________________ Phone ____________________
     ANY HEALTH ISSUES      ________________________________________________________________________________________
     FOOD                                Amount ___________/cups Check if applicable ___AM __PM     CAN HAVE TREATS (Yes/No) _____
     FOOD PROVIDED            BRAND________________________________________________________________________________

     ADDITIONAL SERVICES   _______________________________________________________________________________________
    All dogs must be up to date on all vaccinations or provide Titer Certificate from Veterinarian.  A copy of the medical record must be

    provided prior to boarding.  If not provided, you authorize Shadow’s Retreat to administer any necessary vaccinations and agree to pay

    the costs  (DHPP $30.00 & Bordetella $30.00).  Bordetella must have been given within the past six months, if not it will be given upon


PROBLEMS? Please indicate yes or no (Y or N):
Dog Aggressive__                        People Aggressive__                   Toy/Food Aggressive ___                Chews__
Digs__                                            Barks__                                          Runs Away__                                     Unruly__
Escapes__                                      High Jumper__                             Shy__                                                  Afraid of Noises__
Toy Possessive__                         People Possessive__                   Separation Anxiety__                      Stool Eater__
Picky Eater__                                Soils Crate__                                Jumps Up__                                        Allergies _____
Growled at someone ___           Bitten someone ___                    Flea/Tick Treatment_____               Prior Boarding_____                                  Crate Trained_____                      Chews Bedding _____                  Eats Bedding _____                           Adopted_____                                                                                   
Knows commands ______  List commands ________________________________________________________________________________________________________
 Is there anything else we need to know about your dog? ______________________________________________________________________________________
How did you hear about us? ______________________________________________________________________________________________________________________