Mistress
GLOW
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Formal Petition · New Client Form
Approach
with intention.
Detailed intake form for new clients
I
Chapter 1 of 21
I
Initial Information
II
Waiver
III
Informed Consent And Legal Notice
IV
Planning Your Scene
V
Safety
VI
Medical
VII
Physical Limitations
VIII
Your Experience
IX
Impact Preferences
X
Anal and Balls
XI
Breath Play
XII
Body Part Torture
XIII
Role Play
XIV
Fetishes
XV
Humiliation
XVI
Being Forced
XVII
Sensation Play
XVIII
Electric Play
XIX
Wax Play
XX
Suspension
XXI
Bondage
Chapter I
Initial Information
If you do not fully complete the intake process Mistress will have to spend an extra hour (at your cost) going through it. Therefore, please complete the entire form to get the most out of your experience.
Email Address
·
We will contact you at this address.
Legal First Name
·
Legal Last Name
·
Preferred Pronouns
·
Date of Birth
·
Phone Number (with any extension)
·
How should I contact you (select all that apply
·
Phone
Email
Leave voice mail
Text
Emergency Contact Name
·
Emergency Contact Phone Number (with any extension)
·
All replies are kept in private correspondence.
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