First Time

First Time … If We Have Not Met Before

I have tried to make my website as informative as possible regarding my intentions, desires and offerings. If you have further questions or specifics to discuss with me, I am happy to do so, but only after the completion of my screening process.

Below is a form for you to fill out; it will take me a day or two to complete screening and a variable amount of time to set a date. Please answer as completely and honestly as possible.

While I appreciate some might find my screening to be invasive, I will gently remind you that absolutely nothing I do is arbitrary, everything has a reason & I would hope that in coming to see me you would want me to feel as safe and secure as possible. However, I am flexible… the goal here is safety for both parties, not to cause initial discomfort. Additionally, these forms will eliminate a ten email back and forth and save us both time, as I will have everything I need to set up our meeting, all in one place.

Please use good sense and delete any form of communication with me and be very careful when writing down my information on paper. I’ve found putting my address and phone number on a donation envelope to be a very good idea.


First and Last Name*

Real life verification* (linkedin, place of employment, alma matar etc.)*

What do you prefer to be called?

Age (approximate is fine):

Email address* (make sure this is a secure email and does not contain your real name)

Phone Number *

What city do you live in/want to meet*

Where did you hear of me?

What type of appointment would you like to book* (there are three options):

What length of appointment would you like*

When would you like to meet up* (please list a few options if you are able)?

Would you prefer text or email directions to me and my phone number (on the day of our appointment)?

Allergies, injuries or limitations I should be aware of

Preference of attire that I wear?

Any questions?

Have you read my etiquette and FAQ pages? (Please do if you havent and ask questions if you have them)?

* means Required