Reservation Form

Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Preferred Date of Meeting
Time
Location (Incall/Outcall)

IncallOutcall
Duration
Which city is this for?
Tell me a bit about yourself so I have an idea of who you are and if we'll be a good fit. (E.g. Age, occupation, interests.)
Screening

One of the following screening methods must be completed by first time clients in order to be scheduled for an appointment. This form is sent directly to me and no one else will have access to this information. Screening is discreet and confidentiality is highly important to me. This is just to verify that you are a safe person to be around and will ensure that we have a mutually comfortable experience together.
Select one of the following screening methods:

Option 1: Photo IDOption 2: Employment informationOption 3: Verifiable provider referenceRepeat client
Option 1: If you chose the photo ID selection, upload a clear, unaltered photo of your ID here.

Browse Files

Cancelof
Option 2: If you chose the employment information selection, please provide info here. E.g. Company name, website address, and/or Linkedin profile/social media.
Option 3: If you chose the provider reference selection, please leave their email as well as their social media handle or link to their website/online advertisement.
Other comments/questions (optional):
How would you like me to contact you?

E-mailText
I have read and agree to the deposit/cancellation policy below:
Once screened, I will reach out to you for a deposit to reserve your date. For the deposit, 15% of the donation is required. This can be sent through e-transfer or an e-gift card of my choosing.

I understand that circumstances come up and you may need to cancel your booking. If you must cancel within 24 hours, the cancellation fee is 50% of the booking cost. Prior to 24 hours, the cancellation fee is just the deposit. (15%)
Should be Empty:

Screening