For us to get to know each other, please submit the information requested on my screening form. Regarding your privacy, I am always discreet and respectful.

I ask for your information solely for the purpose of screening for my safety and peace of mind. All information you provide is kept entirely confidential.

If you feel it is more personal to send me an email, go right ahead. Simply make sure you include all the relevant information from the form. I will get back to you as soon as possible – and If I don’t answer right away, allow my photos to keep your mind occupied until I send you a note!

I do prefer to communicate via email as it is the most discreet option for our correspondence. After screening, last-minute bookings made by text messaging are also welcome.


For safety purposes screening is required. I accept any of the following options: references from other companions, TER Whitelist, Preferred 411, employment verification, or a copy of your photo ID. Please email me if you have any questions.

NOTE: For employment verification I only require your LinkedIn profile or company website with photo. If neither are available I also accept company phone numbers along with your direct line.

I’m excited to meet you!

    Your Details

    * Full Name:

    * Email:

    * Telephone Number:

    Appointment Details

    * Date of Booking:

    * Time of Booking:

    • :

    * Duration:

    * Incall/Outcall

    * Please provide your location name and address:

    * Please provide your location name and address including country & city:

    Screening Options
    (choose your preferred method of screening)

    1. Companion References
    Minimum of 2 references from companions you have visited in the last 6 months. Name, website, email + phone number.

    * Companion reference 1:

    * Companion reference 2:

    2. Employment Verification

    * Position:

    * Company name:

    * Company main phone number:

    * Your direct line:

    * LinkedIn page:
    with 250+ connections and profile picture.

    3. ID

    * Please provide a copy your photo ID:

    4. P411

    * Please provide your P411 details for verification:

    Additional Information

    * Where did you hear about me?

    * If other, please state below:

    * Please enter the directory name below:

    Would you like to share your picture with me? If yes, please upload.

    Comments / questions / requests...