Bookings/Screening

If interested in arranging some time together please fill out the BOOKING FORM BELOW or copy and paste the below info into an email and send to [email protected].

 

First Name:

Last Name:

Phone Number:  

 

Contact Preferences 

Is it ok to call?

Is it ok to text?

Is it ok to leave a voicemail?  

 

I have preferences just like you do so please answer the following accurately:

What is your race/ethnicity?

What is your age?  

 

Please provide any Memberships/Handles you have on the following sites:

Date-Check:

P411:

TER:  

 

Provider references that you have seen recently (in the last six months) *I highly recommend you contact your references to let them know that I will be reaching out to them in order to expedite the screening process.*  

 

Provider Reference #1 

Name:

Email:

Phone:

Website  

 

Provider Reference #2 

Name:

Email:

Phone:

Website:  


Provider Reference #3

Name:

Email:

Phone:

Website: 

 

PLEASE NOTE: Should you not have any references, don’t give up hope … read the information below for other screening options:  

 

If you do not have recent references please provide at least two of the following:  

- A copy of your driver's license

- A copy of your business card

- A company website link where you are clearly listed as an employee/owner/contractor etc.

- An email from your work email address (to prove that you own the email account)

- Specific instructions on how to verify you through contacting your place of work  

 

** Please Note: We value your discretion and your discretionary needs so please provide specific details about any special communication needs you might have **