LIVE SESSION APPLICATION

If you want to have a session with me you must submit the following application. This will tell me the kinds of things you are into, where our compatibilities lie and critical information about your health and BDSM limits. I will not see anyone unless I believe we have compatible fetishes.
When submitting this form, always specify days and times when you are available for your appointment. I prefer that you give a range of times so that I can choose what is most convenient for me. You should not submit this form more than two weeks ahead of time. If you are traveling here and need to know if I will be in town when you come contact me directly. Do not use this form for anything other than scheduling a live session with me.

CONTACT INFORMATION Name:
E-Mail Address:

*Be sure to enter this address correctly! If you give me an incorrect e-mail address I have no way of contacting you.

General Background How old are you?

When did you first realize your submissive nature?

Gender: Male Female Transgender

Rate your Pain Threshold from 1 to 10 with 10 meaning it is extremely high.

Have you visited a Professional Dominatrix before? yes : no :

List here any comments you have about your past BDSM experiences.

Activities

The following are some of the more common activities that I use in my sessions. These are the kind of things I either find most popular or just enjoy blending into many of my sessions.
Rate these from 1 to 10 with 10 meaning you enjoy this activity the most. Use a value of 1 to indicate that you are uncomfortable with an activity. I do give precedence to higher rated activities, it makes the session more fun for both of us. However, rating something high does not guarantee that I will do this in your session.
This is not by any means a complete list, and there are many other kinky things I enjoy. Since I wanted to keep this application relatively brief I have provided a write in section for you. If you are interested in any activities that I do not have listed here, you should request them there. You may also use this space to note anything you consider essential to your submission.

Spanking		Humiliation
Whipping		Foot Worship
Paddling		Crawling
Caning		Being Led on a Leash
Ice Torture		Verbal Abuse
Hot Candle Wax		Spitting into your Mouth
CBT		Golden Showers
Nipple Torture		Cross Dressing
Trampling		Human Ash Tray
Face Slapping		Kickboxing
Hair Pulling		Submission Wrestling Holds
Being Bound to a Cross		Hypnosis
Being Bound to a Table		Kidnapping
Being Locked in a Cage		Sensory Depravation
Chain or Rope Bondage		Ritualistic Goddess Worship

What other kinky things interest you?

Limits Tell me about any limits you have. Include any activities you cannot tolerate or concerns such as lasting marks. Don't be redundant, criminal activities such as anything involving animals or children are already forbidden.

Medical If you have any medical problems that I should know about list them here. Include anything that may limit your performance such as bad knees.

Scheduling Do you live in South Florida? yes : no :

If you do not live in South Florida where do you live and when will you travel here next?

Apointment Time: Session Length:

*Avoid confusion, provide full dates and times, always use Eastern Standard Time(EST) and include am/pm.

Other Tell me anything else you think I should know.

You will be sent an automated confirmation email shortly. If you do not receive this, check your junk mail and if the message is not there contact me to alert me to the problem.

Serve Me Now Slave

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18 U.S.C. §2257 Record-Keeping Requirements Compliance Statement