Appointment & Booking Request
Thank you for your interest in scheduling time with me. Please complete the details below to help me prepare for our session and ensure we make the most of our time together. NOTE: Submitting a booking does not guarantee approval. If the information submitted cannot be verified, an alternative screening method will be required.
First Time Visit?
*
Yes
No
Requested Duration & Time
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Please Select
15-20 min (incall only)
30 min
60 min
90 min
2 hr
4 hr
6 hr
8 hr
Overnight
Fly Me To You (Travel Request)
Overnights are only available for outcalls
Fly Me To You (FMTY)
*
Fly Me To You (FMTY) is a specialized request that requires a 20% travel deposit, plus the cost of roundtrip airfare and a 3-star or higher hotel where I can check in. Please provide your phone number, email address, and any additional details you would like to include. After submitting your details and completing the screening below, I will get back to you as soon as possible.
Any add-ons?
*
Please Select
Yes
No
Add-on total
*
Enter the total amount for the add-ons you want
Location & Booking Preference
*
Please Select
Incall (My Location)
Outcall (Your Location)
Outcall location?
Include the address where you'd like an outcall
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
First Name
*
Year of Birth
*
e.g., 1978
How would you like to screen?
*
A reference from an established and active provider
Employment Verification
Professional Linkedin Profile
Established And Recent Review History (e.g. P411 or TER)
Blank Email to me from your work email
Selfie with your Driver's License
Real Number, Name, Age, work, and a Selfie
Work Email
enter your work email here
simplebookings@protonmail.com
Email me at this address using your work email
Online Handle (ter, hx, pdelights, TNABoard, etc)
*
Share the Username and list the website, or share the URL for your established profile
Submit Screening
*
Please provide the relevant link or details necessary for verification. The more complete the information you provide, the easier it will be to process your screening promptly.
I.D./Driver's License
*
Browse Files
Drag and drop files here
Choose a file
Use this to submit an I.D. or Driver's License for screening purposes.
Cancel
of
Employment Verification
*
Browse Files
Drag and drop files here
Choose a file
Sumbit proof of employment
Cancel
of
Work Email
*
e.g., intel@example.com
Linkedin Profile
*
Share a link to your established LinkedIn Profile. Your Linkedin needs to have a visible picture attached, a work history, and a good amount of connections or it will not be accepted
Recent Face Selfie Holding Up 2 Fingers
*
Browse Files
Drag and drop files here
Choose a file
Recent selfie holding up 2 fingers. No glasses/headgear. Do not let your fingers obstruct your face.
Cancel
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Recent Face Selfie (*Not Required, But Appreciated)
Browse Files
Drag and drop files here
Choose a file
Recent selfie holding up 2 fingers. No glasses/headgear. Do not let your fingers obstruct your face.
Cancel
of
Provider Reference
*
Enter the name or URL of the established and active provider you'd like to use as a reference. Please note that I will contact them and ask them if you are safe to see
Provider's Phone Number
*
Please enter the provider's Phone Number
Format: (000) 000-0000.
Terms and Conditions
*
Email (Optional)
example@example.com
Additional Details?
Include any additional details you'd like to add or share
Phone number
*
* Please provide a genuine, currently active phone number. VoIP, TextNow, temporary, or otherwise unverifiable numbers may not be accepted.
Format: (000) 000-0000.
Submit Form
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