Session Request Form
One step closer to reality
Full Name
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First Name
Last Name
DOB (mm/dd/yyyy)
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Phone Number
*
Please enter a valid phone number.
Email Validator
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Have you sessioned with a pro dom before? List 2 references, if not, put n/a
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Include emails and websites/media
Preferred method of contact?
Level of Experience
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Exploring/beginner
A few sessions
Semi-regular
Seasoned
Type of Session
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Please Select
half hour
power hour
2 hr
6 hr
FMTY
Double Domme
Add Ons?
Specialty
Panties
If specialty, which?
Introduce yourself to Me. Your response will help me determine if we have similar interests.
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Existing health issues, allergies, current medications?
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Blood thinners, rock fruit allergy, etc
Hard limits
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How do you want to feel during and/or after the session?
What is your preferred form of aftercare? Do you need it for this scene?
Why do you want to session with me?
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How did you hear about me?
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Do I have your permission to take pictures and/or videos of our session for my platforms? Face and distinguishable features can/will be covered upon request.
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Yes
No
How will you be submitting your deposit?
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Please Select
Cash App
Venmo
Visa Gift card
These are the only forms of payment I accept for deposits
Submit
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