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Booking Form
Full Name
*
Email Address
*
Cell Number
City of Residence?
*
Chosen City for our Date?
*
Are you a local, travel here often, or just visiting?
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Are you a local, travel here often, or just visiting?
A
Travel here Often
B
Just Visiting
C
Local
Incall or Outcall?
*
*
For outcalls, what general location or specific hotel?
Date and Time
*
*
Alternative Date and Time
*
*
Duration
*
Are you a couple?
*
Fee for couples is 1.5x my rate.
Screening
*
Photo ID
Click to choose a file or drag here
Size limit: 10 MB
I only need to see your photo, name, and birthdate. Please obscure all other details.
I prioritize those who provide me with their ID or Linkedin.
Work Verification (LinkedIn / Website / Company Card, etc)
Provider References if available
Provider Website/Ad/Social
Provider Email
Date Seen (Doesn't have to be exact date)
Tell me about yourself, or anything you'd like me to know!
Shall I add you to my travel notifications?
Shall I add you to my travel notifications?
A
NYC
B
Boston
C
DC
D
Other Locations (email me!)
You understand that:
*
You understand that:
Your identity and safety must be verified.
A small deposit or gift is required before we meet.
You will not publish reviews of our time together.
You regular screen yourself for STIs
You regularly inspect yourself for any skin conditions
Submit
