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First impressions are everything, therefore only courteous and personable inquires will be entertained. Make sure you've read my website in full before contacting. Please only complete this form if you are ready, willing and able to provide screening information and send a deposit once you hear back from me to confirm the booking. I look forward to hearing from you. 

Please complete this form on a desktop computer otherwise you can email me directly with responses to the following questions here:

Full Legal Name*


Cell* Please use your real number, I will not call or text without consent.

Email Address* Make sure this is correct or I will not be able to reach you.

City in which you reside*

City of our meeting*

Where, incall (you come to me) or outcall (I go to you)?*

When, please include the next three possible dates and times you are available to meet *

What type of experience do you seek? (see considerations pg.)

How long would you like to see me for?*

Intro & Desires*

Ex. How do you spend your time? What are you passionate about? What brought you here? What attracted you to me? How do you imagine our time together? Include kinks you'd like to explore (if applicable).

Screening Info*

(All information is confidential, non negotiable and for my safety)


You must submit a minimum of two of the three options for adequate screening.


Option #1: The names, email addresses and websites or ads of two independent, active providers who you have seen within the last year.


Option #2: Work info including company email address, website, your title and LinkedIn profile.

Option #3: A selfie of you holding up your driver's license or photo ID (you may blur your address) Please submit via email

Where did you find me?*

If adequately completed forms will be responded to within 48hrs. 

*I prefer 24hrs advance notice for all bookings with new friends. 

** A 20% deposit will be requested to secure a date. 

Thanks for submitting!

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