Part 1 General Information

What is your email address? ex: Mistress@SxySadist.com <mandatory>

What is your first name?

Where are you from? (city/state)

If not from the area, when do you plan to visit Northwest Connecticut? (approx date)

Phone/Pager (if pos.):  

Your Age:  

Gender:  
Male Female Cross dresser Transgendered Couple

Marital Status:  
Married Single but attached Single and free Divorced Widowed Poly-amorous

Sexual Orientation:  
Straight Bi-curious Bi-sexual Gay/lesbian

Health related issues I need to be aware of that may impact our session: (please list past or recent chronic conditions, injuries, disabilities or phobias) Also list any especially sensitive areas:

Please inform me of any emotional issues that you feel may cause a potential trigger or bad reaction: (rape, incest, child abuse, race concerns) or anything that I should be aware of that is a potential problem for you in a scene emotionally. 

I am occasionally willing to barter for services. What special skills or services do you have to offer?

Part 2 Scene Basics:

Your preferred power position:   
--Please Choose-- Submissive/slave Part-time Kinkster Fetishist Switch Dominant Undecided Curious

Describe your SM experience thus far if any:

If experienced how many years in the scene, or how long interested in it?

Can you provide a reference? (Someone active in the lifestyle, a Pro Domme,
or other scene related individual) If so, who?

What, if any, marks are acceptable to you & for how long?
(Please note: Some BDSM activities have the potential to leave temporary marks such as light bruises, welts, or imprints like rope marks on the body. Although I am very good at what I do and rarely leave marks on people that do NOT wish them, I cannot absolutely guarantee whether you will get a mark or not or how long a mark will last.)

What do you feel is the most important element in a BDSM scene?

Which choice best describes your interest?
--Please Choose-- Sensation play Psychological play Both are equally important I just want to serve I just want a specific fantasy fulfilled

Are there any particular areas you feel you would like to challenge explore? What activity is highest on your "wishlist"?

Please briefly describe what you envision for a first scene with me. I want at least a few sentences in this field or don't bother continuing.

Do you wish to explore service in your submission? If so what kind and how deeply?

What you picture the Mistress wearing.. (be careful, this is a set up question! I don't promise to wear what you ask for and I turn away a lot of people based on inappropriate answers here!)

This section gives me deeper insight into what makes you tick & turns you on. Please describe at least 3 qualities that you envision when you think of your ideal dominant or submissive.