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◆ Who are you? ◆
Name
*
First Name
Last Name
E-mail
*
example@example.com
◆ Tell me more ◆
Polite Introduction
*
Tell me a little about yourself and why you wish to serve me. I am selective — I seek genuine chemistry, intention, and respect. Be clear, concise, and honest.
Session Type
*
In Person ($500/hr)
Dinner & Domination ($1,500 / ~4 hrs)
Shopping & Outing ($300/hr)
Preferred Date(s)
*
Minimum one week notice for new submissives.
Start Time & Duration
*
Providing multiple options saves us both time.
Location
*
San Francisco
Oakland
Fly Me To You
Other
◆ Your INTERESTS ◆
Select all that apply.
Interests
Sensual Domination
Sensory Deprivation
Sensory Play
Mindf*cking / Sensory Subversion
Tease & Denial
Wax Play
Venus 2000
TENS Units
Violet Wand
Flogging
Spanking
Paddling
Caning
CBT
Shibari / Rope Bondage
Wrist & Ankle Cuffs
Bondage Suspension
Cling Film / Mummification
Games / Scenarios at Your Expense
Slave Training
Chastity Training
Plug / Strap-On Training
Feminization
Dollification
Objectification
Pet Play
Foot Worship
Orgasm Control / Edging
Collar & Leash
Role Play / Scenarios
Cuckolding
Financial Domination
◆ Your DESIRED FEELINGS ◆
What do you want to feel? Select all that apply.
Desired Feelings
Like I don't know what's coming next
Controlled
Helpless
Transformed
Physical limits tested
Feminized
Owned by Mistress Akira
Humiliated
Objectified
Taken apart
◆ Your BOUNDARIES & hEALTH ◆
Boundaries & Hard Limits
*
Your limitations, hard nos, and turn-offs. Be specific. Ex. marks or no marks?
Health Concerns & Medical Conditions
*
Include anything relevant — allergies, injuries, conditions, medications. Your safety is paramount.
◆ yOUR EXPERIENCE ◆
Past Experience
Briefly tell me about your previous experiences with kink/BDSM. What worked, what didn't.
◆ Screening ◆
References
*
Provide a minimum of two verifiable references from providers you have seen in the past two years — Pro Dommes, escorts, or FBSMs. Include name, email, and website or social media. If you are new and cannot provide references, provide a government-issued photo ID (with info visible) and/or LinkedIn profile. This is non-negotiable — my safety is paramount.
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