You've made it all the way here so it appears you'd like to meet me! Fantastic! Please take the time to fill out this form in its entirety. I cannot wait to meet you , future lover :)


Screening is mandatory and I will not see you if you have not been properly screened. This information is solely used to make sure that you are not a scammer, a serial killer, or otherwise unsavory. 

Name *
Phone *
No fake numbers or text apps please.
*Please note that I am an equal opportunity provider. This information is solely so I know who to expect/look for.
(e.g.) Outcall to the Four Seasons in Midtown at 7pm on July 29th. Please also include the city.
Please include provider's name, email, and website. If you do not have any recent references, I will need to screen you more intensely.
This is honestly the most important question on this form. However, I will not discriminate based on how you answer.