Session Request Intake Form
this site has encryption aka your information is safe!
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Address as it appears on your ID you are submitting
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What date and time work best for you? My travel dates are at ladylaz.com/traveldates.
What services are you interested in? Here are my rates for both sexual sessions with ME and HARD (femme)domination on YOU. LIGHT (femme)domination is 50% of these rates. Comment below if you need clarification based on your session needs. (anal is + $300) 60 minutes $600 | 90 minutes $900 | 2 hours $1,200 | 3 hours $1,300 | 4 hours $1400 | 6 hours $1600 | 8 hours $1800 | 16 hours $3600 | 48 hours $4800
Are you willing to put a deposit down for screening purposes that goes towards your session and my time? It's $60. Please be advised, this is non negotiable.
Yes
No
Please provide your ID here. It needs to be clear and legible. I also need a selfie of you with your ID clear and legible so I can see it's you!
Submit
Should be Empty: