Reservations

* Required Field

About You

Name: *
Age: *
Race: *
City, State: *

Contact Information

Email: *
Phone # (No VoiP #'s or Call/Text apps): *
Accept SMS/Text: *
Best Times to call: *

Appointment Details

Preferred Date (Example : 7/16/2022): *
Preferred Time: *
Desired Duration: *
Incall or Outcall:

Provider Reference #1

Provider Reference #1 Name: *
Provider Reference #1 Phone: *
Provider Reference #1 Email: *
Provider Reference #1 Website: *

Provider Reference #2

Provider Reference #2 Name:
Provider Reference #2 Phone:
Provider Reference #2 Email:
Provider Reference #2 Website:

Deposit and Cancellation Policy

In the event that you need to cancel, you must allow me no less than 48 hours notice.  Failure to do so will result in the forfeiture of your deposit and a $2OO re-booking fee.

I acknowledge that I have read and agree with the deposit and cancellation policy: *
Yes
I acknowledge that a deposit is required to secure this booking: *
Yes
How will you be handling the deposit? *

I am more than happy that you have chosen to spend time with me!  I can assure you, you won't be disappointed.  Please complete this form with ALL of the requested details, this form serves as a proper introduction and will help me determine if our availability is compatible.  Appointment requests lacking the required information will go unanswered.