Name
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Full legal name required
First Name
Last Name
Preferred Name
Gender
*
Pronouns
Age
*
Phone Number
*
Real phone number required. No Google voice or burner numbers. For verification only (I will not call unless agreed upon.)
(###)
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Introduce yourself
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Who are you outside of kink (hobbies, work, etc.)? What is your kink story?
How would you describe yourself?
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Pick as many as you feel is accurate
Why do you want to serve Me in particular?
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What type of service are you inquiring about?
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Classic Domination
Dungeon and Dinner
Outing
Remote
What is your preferred demeanor?
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What are you interested in exploring with Me?
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List specific kinks, feelings.
What was your best and worst session and why?
Write "N/A" if new.
Any health concerns?
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List any relevant physical and psychological limitations, allergies, recent pain, medications
What are your hard/soft limits?
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List specific activities, marks, words
I like to document my sessions. Do you consent to photos/video?
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These may be shared on My social media
Where did you find Me?
What option would you like for our consultation?
How would you like to be screened?
References
Photo ID
I have read and agree to the deposit and cancellation policy.
*
I understand that no illegal activity is offered or implied.
*
Comments, Questions, Concerns
