Client Screening form

Booking and Screening Form

1st TIME CLIENTS ONLY✨ All other clientel looking to book a session must use the other form provided on my contact page.
User IP Address & Location
CONTACT INFORMATION

cliento get in touch with you to follow-up with your form submission as well as added to your client file on my contact
Your Name *

FIRST LAST
Phone Number *
Ex. 555-555-5555
Email *
Please enter your personal email address here
Preferred Method of Contact *

Text message Phone call Email
About You 🥰

Client information regarding physical, digital and societal characteristics.
Physical Characteristics *
Where do you reside? *
Please give the general area that you reside | EX. Hillcrest Park neighborhood in MV, Sedro-Woolley, Bellingham, etc.
What is your occupation? *
Company or business name NOT required.
Any disabilities? YES or NO and if yes, please explain.
I only need details that are relevant to our session(s) together so that I know if I am able to accommodate you or not AND how to best do that.
Online Presence

This section is where you link your social media and hobbyist accounts
Please provide usernames and/or profile URLs of social media accounts (if you don't have any enter "N/A") *
ALL of your hobbyist handles and usernames to escort ad sites (enter 'N/A' if you don't have any) *
How did you find out about me? *

Escort advertising plarform Social Media Hobbyist review board Word of mouth AKA referral
List the website that you discovered me on OR if referred by someone then provide their name + email/phone *
Name of the website is fine but if you can provide a link to the exact ad/site/profile I'd appreciated it so much!
Our Session🔞

This section consists of basic details about the sessions
What is the date of the session that you'd like to schedule? *
What time is the session you'd like to book? Please choose from the drop-down options below

Hour Minutes

AM/PM Option
If you are unsure of the EXACT time of the session then give your most accurate estimate of a time range
example: 'Between 1pm -3pm, my kid has an appointment that day so I'm not 100% sure when its over.'
Incall or Outcall? *
If the answer is outcall, then where to?
Please give the location of the outcall. It can be as general as the city or as specific as an exact address.
What type of session are you booking? *

Regular VIP Fetish GFE
Duration *
List the length of the session💖
DEPOSITS ARE REQUIRED FOR THE FOLLOWING SCENARIOS :

• All outcalls that are outside of Skagit County (+ Anacortes & Oak Harbor)

• Sessions pre-booked 2 or more days in advance

• All sessions longer in duration than 2 hours

• If you have a history of last minute cancellations, NO CALL/NO SHOWS or ghosting.
What will be your method of payment for your deposit?

Cashapp Venmo
How important is chatting and gaining a rapport before diving into physical acts? *
CONDOMS ARE A MUST AND THEY ARE REQUIRED FOR ALL FULL SERVICE SESSIONS.

This is something that I am not willing to compromise on or negotiate about so please respect my boundaries by not requesting bareback full service at any point in our interactions.

Thanks💖
What is your condom preference? If any.

Trojan bareskin Trojan for her pleasure Magnums No Preference I prefer to bring my own because I am allergic and/or sensitive to certain materials
If you are bringing your own condoms, what kind are they?
Please list the brand name and type of condoms (ex. Trojan bareskin, Magnum, lamb skin, latex, Lifestyle for her pleasure, etc.)
Have we ever met before? And if so, did you previously submit screening information? *
UPLOAD SELFIE AND/OR SIGN *

(Acceptable file types include pdf, doc, csv, txt, mpg, jpg, jpeg, png, gif, etc.)
Cancel of
Terms and Conditions of Adult Service Provider - Client companionship agreement
𝓣𝓱𝓪𝓷𝓴 𝓨𝓸𝓾 𝓯𝓸𝓻 𝓽𝓪𝓴𝓲𝓷𝓰 𝓽𝓱𝓮 𝓽𝓲𝓶𝓮 𝓽𝓸 𝓯𝓲𝓵𝓵 𝓽𝓱𝓲𝓼 𝓸𝓾𝓽

Now create your own Jotform - It's free! Create your own Jotform

Booking and Screening Form

CONTACT INFORMATION

About You 🥰

Online Presence

Our Session🔞