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  • Phone information is required for screening purposes.  I will not contact you by phone or text unless you indicate below that it is ok for me to do so, in which case I will ONLY contact you by phone or text within 30 minutes of a scheduled appointment together.  (i.e. in case of traffic, running late, need directions, etc)  IF I am not able to make contact via email first.

  • Companion References

    Please provide me with the following contact information for at least two reputable companions you have spent time with recently that will vouch for you as a safe and reliable client.  I am unable to accept agencies as references.  Please fill out all requested contact information for your references.  I need to be able to first research and contact your references.  Providing just a companion's name & city is not sufficient.  

  • Companion Reference #1

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  • Companion Reference #2

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  • Providing your handle/username for the following services will help speed up verification.  At this time, I am unable to verify through other pre-verification services on the web, however TER and P411 are the two most popularly used.

  • Scheduling Information

  •  -  - Pick a Date
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  • Should be Empty: