So you're curious and ready to try?


 If we haven’t seen each other before I’ll need you to fill out this form. You may fill out this form and submit it via email to

Email address:
Phone number: 
Desired session length:
Top 3 desired session dates and times:

How you heard about me:
Appointment interests:
Level of experience with BDSM: 
Do you have any medical problems I should be aware of? (Bad knees, latex allergy, high blood pressure):
Do you have any references from past providers?:

Don’t fret if you have little/no experience with seeing a provider or if you have little/no experience with kink and BDSM, I am happy to accommodate those with good manners.

For our first meeting, you will be asked to make a small deposit in order to ensure your seriousness and commitment to our playtime.  I do not discuss tribute until we have established our compatibility via email, but my tribute starts at 280.

If you are interested in only scheduling a phone or cam session with me, you need not fill out the form above. Simply email me or send me a message on NiteFlirt to schedule a date and time.