Please don't see this form as your making specific requests of me. The purpose of this form is to assist me in deciding who you are, what BDSM or Fetish Play means to you and whether or not we are suited. I am not a mind reader and I see clients as individuals with different needs and desires.
You may ignore sections of the form that are not relevant to you, but please ensure that that the areas that are relevant are fully completed.
I am receiving incomplete applications with incorrect email addresses. Please take the time to complete this form fully and properly. Bearing in mind that I am likely to be holding your balls in my hands some of you are remarkably vague.
The last section 'Supporting Information' is compulsory. If it isn't completed then I hit the delete key.
Name
Age
Email address Please check carefully
Mobile telephone number (don't worry, I won't call you) Level of experience
How many Mistresses have you already seen?
How often do you session?
How important is it for you for the Mistress to be dressed in fetish clothing?
Do you have any clothing fetishes that you would like me to wear?
No Yes
Please give further information regarding fabric ie stockings, leather, rubber: Please bear in mind that I cannot and will not guarantee to fulfil your request. I won't, for example, wear rubber and corsets on a very hot day. Nor will I wear just a basque and stockings, I don't wear lingerie: I am a Dominatrix, not an underwear model. Nor am I a clothes horse for your fetish.
Be honest about your health. I have enough skeletons in my closet, and bodies in my garden, as it is.
Please tick all the conditions that may be relevant to the activities I normally enjoy and add any details to the comments box below. Allergies (latex, creams, shellfish etc) Asthma/other breathing problems Back pain Blood pressure (high or low) Cardiac disease Claustrophobia Diabetes Epilepsy Joint pain Laser eye surgery (important if interested in extreme breath play) Pacemaker Skin conditions Stroke Surgery scars Viagra (or similar in the last 24 hours) Anything else you think I should know about
Comments:
Note: If you have low blood pressure and take Viagra (or similar) your blood pressure can drop so dangerously low that you could fall into a coma. If that doesn't kill you I bloody well will! Not on MY watch mister.
In general, can you be marked? I will ask about marking during CP further down the form.
Please specify:
What do you consider yourself to be? (please tick all that apply)
Slave Submissive Masochist Patient A bottom Male offender Don't know
What is your motivation? What do you want to get from the session? (please tick all those that apply)
I want to suffer for the Mistress/Nurse My pleasure comes from providing pleasure for the Mistress/Nurse I like certain activities to be done to me, for me, the way I like them done. I want us to play as an equal partnership I don't know yet
What sort of play do you prefer?
Mind play (lose/lose situations) Fear play (I want to feel really scared) Sensual and Erotic (I want to be teased) Forceful and Dominant (Bend me, shape me, any way you want me) Sadistic and Cruel (do your worst Mistress)
What do you need at the beginning of the session? (please tick all those that apply)
A glass of water A pre-session chat to calm my nerves A pre-session chat to discuss concerns Straight into the session please Be in role from the start
What do you need at the end of the session? (please tick all those that apply)
Self relief Denied orgasm Ruined orgasm Controlled orgasm A hug Some time to get my breath and gather my thoughts A glass of water A curt dismissal None of the above thanks, see comments below
Additional comments:
Please take some time to describe what you consider Female Domination to be. This information will help me to try and ascertain whether or not we will gel during the session. Good rapport makes for an excellent session that will give both of us a huge buzz that should last for many days. A clash of unmatched expectations can make for a miserable time that will leave us both depleted of energy but not rejuvenated with the feel good factor that should be a natural occurrence in a successful scene.
Please tick all that apply. Don't feel restricted by the scenarios. This is just to help you find particular activities. All scenarios are interchangeable and all activities can be mixed and matched.
Light bondage Heavy bondage
Hemp rope Satin swathes Nylon rope Leather ankle and wrist restraints Rubber straitjacket Leather straitjacket Leather body bag Pallet wrap Masks Blindfolds Gags Facesitting (clothed) Additional comments:
Fingernails Wax (candle and paraffin) Humbler Electric flyswat Cattle prod Cane Parachute Weights Clamps Ball busting Nailing Dog quirt (two tailed whip) Snake whip (singletail)
Additional comments
Please tick all that apply. Dungeon Judicial (assessment required) Basic (no role play, usually for 30min CP sessions only)
Who do you want to be punished by?
Landlady (ordinary clothes) Mistress (usual fetish clothing) Boss Lady (smart blouse, knee length skirt)
Which implements would you like to be punished with?
Hairbrush Ruler Spanker (wooden) Slipper Over the knee Paddle (leather and wooden) Riding crop Flogger Cane Strap
Marks
Be sensible. I can't make any guarantees and everyone's skin reacts differently.
I like to cross dress during session
Knickers Stockings Dresses Hold ups As part of a humiliation scenario
Breast worship Stocking worship Face sitting (clothed) Boot worship Shoe worship .... Foot worship (unavailable at the moment)
Puppy training Maid training Sissification Anal slut training Erotic dancer Forced bi Other (I will consider based on your application) I would like to be filmed for your C4S store to add to my humiliation (masks are permitted, please consider identifying tattoos)
Ball weights Breath play Chemicals Electrics Enemas Internal examinations Needles Poppers Sensation play Shaving (of genitals) Suturing (nipples, foreskin, male pussy) Scrotal saline inflation Urethral sounds Urethral dipsticks Violet Wand Watersports (forced, willing, from; source or glass, please specify below) Nurse uniform (Duty Nurse: Sister Anna List)
Spitting Scratching back with fingernails Face slapping Trampling Knife play Nettle Play
This section is compulsory to sort the genuine enquiries from the bored 'late night form tickers'. It gives you the opportunity to tell me more about yourself in your own words and why out of all the Mistresses in the area you particularly wish to see me. Prove to me that you have read my site and are serious about your application.
Copyright Infringement fact sheet from UK Copyright Service.
