Session Application |

About you

If this is your initial visit with Mistress Alicia, you must fill out this session application. Otherwise, this application is optional.

Name*

Email*

Phone

Enter any special calling instructions below.

Level of Experience*

How you served other Professional Dominatrixes?*

Reference Mistress Name #1

Please enter the name of a Mistress you have served.

Reference Mistress Email #1

Reference Mistress Name #2

Reference Mistress Email #2

How would you describe yourself*

I acknowledge that I understand NO SEXUAL ACTIVITIES are being offered:*

Desired Session Date*

Time*

: HH

MM

Desired Session Length*

Explain your extended session desires

Do you have an Alternate Session Date

Alternate Date

Alternate Time

: HH

MM

Session Demeanor*

Interests*

Please enter your activity interests here.

Pain Level*

Marks*

Marking Limitations

Please list any limitations here

Hard Limits

Please list any hard limits here

Do you have any medical conditions or injuries?*

Medical Conditions

Please list any medical conditions or injuries here.