Appointments - Prescreening

This is requested for all new friends. The information collected is for verification purposes only and is not kept on file. Discretion is most important to me. This is solely to minimize my risk of harm, my safety, and my liberty are of the utmost priority. Fill it out cut and paste this form and email to link below

Please provide the following:
Your full name
Contact phone number
Contact e-mail
Your age
How did you locate my site
Desired Appointment date
Desired Appointment time
 

Please select a package of your preference:
1 Hour Local Introduction in call
1 Hour plus dinner in call
overnight  

Additional comments and time(s) that work best for you
 

TER Handle (a , gentleman with reviews up have priority)
remember to cut and paste to email this form