Screening Form
About Me
Legal Name
*
First Name
Last Name
Age
*
City and State where you reside
*
Occupation
*
Have you ever seen a provider before?
*
How did you hear about me? (specific site)
*
File Upload
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Selfie so I know who to look for when we meet (optional)
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Contact Information
Email
*
Real phone number
*
(No burner phone numbers, google voice, or text app phone numbers must be able to be traced back to you)
Do you accept text message?
*
Preferred method of contact? (No phone call. Please, only whats app, email, or text.)
*
Appointment Details
Preferred Date(s)
*
Preffered Time(s)
*
Length of appointment
*
Location of appointment
*
Special Requests (optional, not all requests can be guaranteed, anything sexual will get you blocked):
Screening Options
Please pick one form of screening and fill it to its full completion, do not leave any of the option you choose empty. I will look everything over and if something is missing I will ask for the information or not reply.
Screening Option 1
References, all of the info below is required
Names of at least two reputable providers you have seen in the past twelve months and that remember you. Please be sure to include their phone number or email and also their website (an ad of them will not count must be their actual website). Also include the approximate date you last saw these providers. Please also write any of your username fourm handles you are apart of (p411, ter, pd, etc) *clicking get screened on private delights is not a form of screening
*If booking a same day appointment please know there needs to be time for your references to respond to the reference request I will send them before our meeting. (It is best to ask/notify the the ladies you are putting down if you can use them as a reference)
Screening Option 2
ID Verification, everything is required
Photo of legal ID (Please only blur out the drivers license number and part of the address. The city, state, and your full name must all still be visible)
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A link to any active social media account that is NOT on private and that you use for your daily life must have several posts and be obviously you. (facebook, twitter, instagram, LinkedIn, etc)
Screening Option 3
Work Verification, everything is required
Work Title
Company Name
Company Website
Linkedin
Your company email OR Phone number with your office extension number:
If you chose email option please send me a blank or discreet looking email to angeliquegunn@protonmail.com (or if you prefer a gmail that has no connection to my ads please email or text me for the email address, I answer email quicker) from your company email so I can verify it is you.
Submit
Should be Empty: