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First and last name
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2
Age
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3
Email
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4
Phone number
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I will not contact you via phone until our scheduled consultation
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5
Occupation
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6
What type of experience are you interested in?
*
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Check all that apply
Domination session
Public outing [meal/drinks/event etc]
Cashmeet
Shopping trip
Financial domination
FMTY
Chastity key-holding
Online service
I'm not sure, I just know I want to serve you
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7
What city are you hoping to see me in?
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8
Where are you hoping to see me?
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NY Capital Region
Hudson Valley Dungeon
NYC
FMTY
Other
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9
How would you describe your experience with BDSM and kink?
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10
How are you hoping to feel during our time together? What kinks or fetishes are you interested in exploring? Why do you want to serve me?
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I expect answers to all 3 questions, or your application may be discarded
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11
Please list any medical conditions, injuries, or allergies I should be aware of:
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12
What are your hard and soft limits?
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I will not accept applications that have "no limits" or "none" as an answer.
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13
How do you feel about being photographed/filmed during our interaction?
*
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Love it
OK as long as my face/identity are concealed
Not for me
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14
Where did you hear about me?
*
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Be specific; "online" is not an acceptable answer
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15
Are you OK with marks?
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Temporary OK
Long-term OK
OK if able to conceal under clothing
Not sure; would like to discuss further
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16
As part of my security screening, I will require you to send me a copy of your photo ID [you may black out the address, license #, etc] Are you willing to do this?
*
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Yes
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17
Have you seen a professional Domme before? If so, will you be able to provide at least 1 reference from a professional you have seen in the past year, including email address and social media/website? [Do not reply "yes" until you have received consent from the professional for me to contact them]
*
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Yes
No; and I understand that I therefore will be required to complete additional screening
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18
All services require a non refundable deposit paid via Venmo, CashApp, or gift card of my choice. Do you agree to comply with this policy?
*
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Yes
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19
Do you recognize that: I do not offer illegal or sexual services - you are paying for my time and attention - violation of my discussed boundaries/limits will result in immediate termination of my services with no refund, as well as you being added to a do-not-book list?
*
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Yes
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20
Is there anything else you'd like me to know?
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