LIVE SESSION REQUEST

Thursday December 26th through Monday December 30th

If you want to have a session with me you must submit the following application. This will tell me about your interests, where our compatibilities lie and critical information about your health and BDSM limits. I will not see you unless I believe we are kink compatible.

Use this form only for requesting an appointment for a live session with me in Michigan. All appointment requests must be made at least 2 hours in advance, 24 hour notice is preferred. Since my availability in the Michigan area is limited you are advised to provide a list of alternate appointment times with your request.

CONTACT INFORMATION

Name:

*Nicknames are acceptable.

E-Mail Address:

*I will contact you initially by email make sure it is correct.

General Background

How old are you?

When did you first realize your submissive nature?

What is your gender?

Male Female Transexual

What is your Sexual Orientation?

Straight Gay Bisexual

SCHEDULING

Appointment Date:

Appointment Time:

Session Length:

Alternate Appointment Times:

*Always use Eastern Standard Time(EST).

*Provide full dates and times including AM/PM.

EXPERIENCE

Have you visited a Professional Dominatrix before?

Yes No

List here any comments or observations you have about your past BDSM experiences.

Activities

The following are some of the more popular activities that I enjoy. This list is relatively brief so I have also provided you a write in session beneath it.You can see a more robust list of my interests at goddessevilena.com/sessions/fetishes.php

Rate these from 1 to 10 with 10 meaning you enjoy this activity the most. Use a value of 1 to indicate that you are very uncomfortable with an activity. I will treat activities rated at 1 as personal limits and will avoid those activities.
I do give precedence to higher rated activities, it makes the session more fun for both of us. However, rating something high does not guarantee that I will do this in your session.

Spanking

Foot/Shoe/Boot Worship

Whipping

Trampling

Paddling

Humiliation

Caning

Being Led on a Leash

CBT

Crawling

Electro Play

Human Furniture

Nipple Torture

Verbal Abuse

Temperature Play Wax/Ice

Spitting in your Mouth

Cross Dressing

Human Ashtray

Hypnosis

Golden Showers

Sensory Deprivation

Face Slapping

Suspension

Hair Pulling

Bound to a Cross

Kickboxing

Bound to a Table

Submission Wrestling Holds

Locked in a Cage

Roleplay

Leather/Rope Bondage

Ritualism or Blasphemy

What other kinky things interest you?
Use this space to note additional activities, fetishes you have, roleplay descriptions and anything else that drives you deep into submission.

LIMITATIONS

Rate your Pain Threshold from 1 to 10 with 10 meaning it is extremely high.

List here any personal or discretionary limitations you have. If you cannot be marked at all be sure to let me know.

MEDICAL

If you have any medical problems that I should know about list them here. Include anything that may limit your performance such as bad knees.

OTHER

Tell me anything else here: examples would be things that really enhance or diminish a scene, questions or concerns, location requests etc.

*You will be sent an automated confirmation email shortly. If you do not receive this, check your junk mail and if the message is not there alert me.

LIVE SESSION REQUEST

Thursday December 26th through Monday December 30th

Serve Me Now Slave