To ensure a fulfilling session for both of Us/us, your Mistress needs some information about you.  The more detail you provide the better your session will be.  All information is kept in the strictest of confidence and is used solely for the purpose of planning your session.

(Please copy and paste into an email and return to Me for consideration)

My email address is: This email address is being protected from spambots. You need JavaScript enabled to view it.

I typically conduct sessions between 2:00pm and 8:00pm weekdays and some Sunday evenings between 6:00pm and 8:00pm (2 hour minimum session on Sundays).  I do not session on Saturdays.


Date/ Time requested:

Duration of session:

Your name and last initial:

Cell phone number:

Your location:

Age:

Physical description (height, weight, etc.):

Marital Status:

Occupation:

Medical Concerns, Physical Limitations:

Viagra and other erection enhancing medications: 

It is not recommended that you take this class of medication prior to a BDSM session.  BDSM activities are exciting by nature and combined with Viagra or similar drugs, undesired side effects like shaking, dizziness and even fainting can result.  If you do take an erectile enhancing drug prior to our session, be sure to disclose this so I can take the necessary precautions.  

Phobias, Abuse Issues:

Eyeglasses, Contacts?

Can you be marked? If so, for how long?

How long have you been involved in BDSM activities?

Do you have references from other Dommes (local, national or international)?

ACTIVITIES I AM INTERESTED IN: (Choose all that apply and list specifics.  Delete the rest.)

  1. Bondage:
  2. Corporal Punishment:
  3. Genital Torture:
  4. Nipple Torture:
  5. Foot Worship:
  6. Trampling:
  7. Tease & Denial:
  8. Face Sitting/Smothering:
  9. Humiliation (describe preferred method):
10. Feminization/Sissification:
11. Strap on Worship/Training:
12. Medical Play/Scenes:
13. Tickle Torment:
14. Pet play/training - puppy, pig, etc.:
15. Cuckold fantasy:
16. Chastity - Key-Holding (CB-3000,6000,The Curve) long or short duration training:
17. Public performance/public outings:
18. Sensory deprivation/overload
19. Toilet Training - GS only:
20. Electro Play/Torture - Violet Wand and the infamous ErosTek.
21. The Venus 2000  - if you don't know what it is, Google it
22. Wax play

List any other activities of interest:


Want to share a fantasy?  Go ahead, here is your chance.

 

How did you hear about Me?  Please be specific.  

 

When submitting this form, your email address will be added to My mailing list.  If you do not wish to be added, just indicate so here, or unsubscribe at any time.


Again, all information held in the strictest of confidence.

Special Note:  Once we set an appointment, your punctuality is expected.  You will be required to confirm your session 90 minutes prior to the actual appointment (unless specified otherwise) by calling Me and getting directions.  If you call late, your session could be canceled and a deposit will be required to reschedule.  Appointments canceled with less than 48 hours notice could incur a penalty and/or a deposit to reschedule.