New Client Intake Form

* Required Field

About You

Name: *

What Service are you booking?

Age: *

City: *

Ethnicity: *

Occupation: *

Relationship Status:

Photo of Yourself (Professional/Clean of your face) *Required: *

Do you agree to show up to your appointment with me? *

Yes, I agree to honor my appointment with you and our time together

I am not sure to be honest. My schedule changes a lot and I may need to reschedule

Did you pay your scheduling deposit? *

Yes, I did.

No, I have not.

I am planning to pay the deposit once you confirm my appointment with me.

Contact Information

Email: *

Phone: *

Accept SMS/Text: *

Best Times to call: *

Appointment Details

Preferred Dates/Times: *

How long of a session are you scheduling? *

Sensual Massage Extras? *

Which location do you need incall/outcall sensual massage? *

Outcall Location (Address & Zip): *

Any recent injuries or surgeries in the last 2 years?

Any medications you are currently taking?

Have you ever received a sensual massage before?

Do you have any allergies to coconut oil?

Yes

Traveler to FL: *

Wardrobe Request(s) (Yoga outfit or Sexy Lingerie or something else): *

Special Request(s): *

Any Likes or Dislikes: *

Lastly....

How did you find me? *

Do you agree to be a gentleman and not text me vulgar, graphic, inappropriate messages?

Yes, absolutely. I will honor the Classy Queen that you are and be your gentleman, Always.

Nope, if I want to ask you for nudes, talk dirty or say vulgar things, I will.

Do you agree to be a gentleman and only text me if it is directly related to the scheduling of your appointment?

Yes, I understand that your time is valuable, just as you understand my time is valuable. Thank you.

No, I will text you about anything and expect you to answer quickly to all of my texts.

Do you agree to schedule a texting, virtual, or girlfriend experience package if you would like to spend more time visiting on the phone? See my FAQ page.

Yes, absolutely. I am excited to get to know you more & spend valuable time together.

No, I will text you as I please, expect a quick response or I wont honor our appointment & no show

NEW CLIENT INTAKE FO

NEW CLIENT INTAKE FO

About You

Contact Information

Appointment Details

Lastly....