SESSION INTAKE FORM

SESSION INTAKE FORM

Miss Ari Canes — Power Presence | Disciplinarian | Psychological Discipline
Client Details:
Name

Preferred NameFull Name
E-mail
example@example.com
Age
Gender
Pronouns

Other
Location

CityState / Province

Postal / Zip CodeCountry
How did you hear about Miss Ari Canes?
Please Specify
What is your past experience being spanked or receiving impact either by a disciplinarian or otherwise?
Level of nudity you are comfortable with. (NOTE: Miss Ari will remain fully clothed at all times.) This question refers to your own clothing. Example: Pants only, underwear, or all clothing, etc.
Desired pain/intensity level
What is your preferred name for me to address you by in the session?
(First name, nickname, honorific, etc.)
How would you like to refer to me in the session?

Other
What tone of address do you desire from me?

Other
What scenario do you want this session to contain?

Other
What are you hoping to feel during and after the session?

Other
7. Is this session meant to be:

Other
Do you want to include a specific mistake, behavior, or stressor for me to address?
(You can be general or detailed.)
Are there any words, phrases, or specific lines you want me to include?
(Feel free to list 1–3 key ones.)
Are there any words or tones you absolutely do NOT want used?
(To ensure boundaries and comfort.)
Pacing preference:

Other
Is there anything else I should know to deliver the exact experience you want?
Thank you.
Your answers give me everything I need to craft a powerful, precise experience tailored to your psyche and your cravings.
I’ll take it from here.

~ Miss Ari
Should be Empty: