Cuddle Compatibility Questionnaire

Cuddle session with Don

Pre-Cuddle Questionnaire
The information requested in this from is used to assure that I am a good match for you to get the most out of a cuddle session. If so, it also helps me to be prepared to provide a cuddle session specific to your needs and wishes. All provided information is confidential.
First Name
Please use the same first name provided on the appointment request
Your Location
City, State, or Zip Code
Alternate Contact Options (Select only those options I may use when contacting you.)

Other
Phone Number

Area CodePhone Number
Email
example@example.com
About you
Date of Birth

MonthDayYear
Gender
Optional
Relationship status (Optional):
Do you have any allergies? (If none, write "N/A")
Do you currently suffer from any contagious or life-threatening illnesses? (If none, write "N/A")
Please describe any physical injuries, impairments, or areas that require special care. (If none, write "N/A")
Have you experienced trauma from any of the following? (Please check all that apply)

Other
Which of the following are you open to sharing during our session? (Please select all that apply)

Other
What are you hoping to get out of our session? (Please be honest and specific)
Statements of Agreement

Please acknowledge each statement below indicating that you understand and agree to these important terms of any cuddle session.
Please view the Code of Conduct
I have read and agree to the Code of Conduct
I agree and understand that a cuddle session does not include anything that could be perceived as a sexual activity or touch by either party. All boundaries will be respected.
I agree to refrain from taking any mind-altering drugs or alcohol prior to or during our session.
I agree to provide payment in full at the time of my cuddle session. The only available payment method for sessions is cash.
I understand that if I must cancel my appointment, I need to provide at least 24 hours advance notice. Without proper notice, I will be unable to schedule another session.
I understand that our session and identities will be kept confidential. However, I also understand that for security reasons, my address and contact information may be made available to a trusted 3rd party who will access the information if necessary.
I understand that my cuddle practitioner may decline to provide or terminate a session at his or her sole discretion at any time, for any reason, including but not limited to reasons of comfort or safety.
I understand that I may decline continuing with, or terminate a session at my sole discretion at any time, for any reason, including but not limited to reasons of comfort or safety.
I CERTIFY THAT ALL INFORMATION PROVIDED ON THIS FORM IS CORRECT TO THE BEST OF MY KNOWLEDGE. I AGREE TO AND/OR ACKNOWLEDGE THE TERMS, REPRESENTATIONS, AND INFORMATION SET FORTH ABOVE, AND FREELY AND VOLUNTARILY SIGN BELOW.
Signature
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Cuddle session with Don

About you

Statements of Agreement