Pre-Session Questionnaire Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Email *Name *FirstLastPhone Number *Name or Nickname *What Kind of Interaction Are You Seeking? *Realtime Session IncallRealtime Session OutcallSkype SessionPhone SessionCash DropShopping TripSocial OutingKink PartyDomestic ServitudeTutelage, Training, or InterviewsWhat is Your Availability? Provide Specific Dates and Times. *What is the Desired Duration of Your Session? I do not offer sessions shorter than 1.5 hours *1.5 Hours2 Hours3 Hours4 Hours4+ HoursOtherDo you have any of the following medical conditions? (This does not in any way effect your chances of seeing Me) *High Blood PressureType 1 DiabetesType 2 DiabetesHeart Disease/History of StrokeMusculo/Skeletal InjuryRecent SurgeryNoneOtherHow Would You Describe Yourself? *MasochistFetishistSubmissiveCuriousPervertWhat is Your Previous Experience with BDSM, Kink or Fetishism? *Describe Your Interests, Kinks, Desires, & Fantasies: *Using My list of interests and offerings, list which ones stand out as elements you would like to include in your session. *What are your hard limits and things you'd like to avoid? *Can you be left with marks? *YesNoMaybePlease provide verifiable references from 1-2 other Dommes or service providers; name and email/phone number (I require references for booking, if you have no references be prepared to provide your government ID, registered phone number and LinkedIn profile). *Submit