Thank you for your interest, I'm truly honored.

Please provide the details requested below to schedule your appointment.

My safety is extremely important to me, so honesty and transparency are necessary for me to feel comfortable with you; please keep this in mind when completing the form.  I have ways of determining who is contacting me, and any deception on your part will make it impossible for us to meet.  I'm happy to accept forms properly filled out with all correct info. 

Discretion is required and I hold all information provided to me in the strictest confidence. In keeping with my desire to protect your privacy, this form is secure using HTTPS/SSL technology to encrypt your data.  This prevents your personal details from being visible to a third-party.   

Your screening form will be sent directly to my password-protected phone, and I will respond shortly. 

"Discretion begins by reaching a well-researched decision regarding what is appropriate and what is inappropriate in a given situation, and then acts to choose only the appropriate words and actions."