Booking/screening form


Date and time you would like to see me:

Age and race:

Type of work you do:

*provide a selfie pic of yourself ( if discretion is priority this step can be overlooked.)

*provide a pic of work ID, or uniform, twic card or anything you feel can help me verify you (or reference)

*Please understand that I am a lady and I have to be as safe as possible. I am a professional provider and I can promise discretion.*  


*Rates are on website*