Appointment request

* Required Field

About You

Name: *
Age: *
Occupation: *
No current references in the last 6 months? No problem! Simply upload a photo of you holding your drivers license up to your face. You're welcome to block off your address but your face, full name and date of birth must be legible:

Contact Information

Email: *
Phone: *
Accept SMS/Text:

Appointment Details

Preferred Dates/Times: *
City you are booking me in: *
Preferred Length: *

References

Names and contact info of providers you've seen before, and any forum usernames or handles:
What website did you find me on? *


I understand that life can be busy, but as a professional companion, my clients are my top priority. Because I book a limited number of sessions, last-minute cancellations directly impact my schedule and income.

Please ensure your schedule is clear for the date and time you select. I offer the flexibility to reschedule a session once at no penalty. However, if the rescheduled session is not kept, the full cost of the appointment will be required via Venmo or, via a virtual giftcard from www.perfectgift.com.  Multiple cancellations will forfeit the opportunity to meet.