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Client Session Form
Name
Your Email Address
Age Verification
I am over 18 years of age.
I am a:
Submissive
Slave
Master
Switch
Fetishist
Masochist
Your Gender
Male
Female
TS/TV
Gender Neutral
Couple
Referred by:
Google
Eros
Max Fisch
Facebook
Twitter
Instagram
Dickie Virgin
Fetlife
Other
Do you wear?
Eyeglasses
Hearing Aids
Pacemaker
Can you be marked?
Yes
No
Medical Disabilities
Level of Experience
No prior experience
Some experience
Experienced
Very experienced
Who do you want to see?
Mistress
Submissive
Switch
Masochist
Fantasy Wrestler
Competitive Wrestler
Master
Session Duration
1/2 hr
1 hr
1.5 hrs
2 hrs
3+ hrs
Overnight
Date of Session
Check all that apply for this session
Boot/Shoe Worship
Caning
CBT
Cross Dressing
Electric Play
Equestrian
Foot Worship
Hot Wax
Humiliation Private
Humiliation Public
Intricate/Inescapable Bondage
Mummification
Nipple Play
Paddling
Rope Bondage
Sensory Deprivation
Slapping
Smoking Fetish
Spanking
Spitting
Sploshing
Trampling
Whipping
Check all that apply for this session
Boss/Employee
Dog Training
French Maid
Infantilism
Medical
Military
Mommy/Child
Prisoner Interrogation
Shower Role Play
Teacher/Student
Check all that apply for this session
Bare Feet
Boots
Corsets
Garter Belts
Gloves
Hats
High Heeled Shoes
Latex
Leather
Nurse Uniform
Police Uniform
PVC
Stockings
Street Clothing
Notes
Submit
