About
Experience
Hypno-Kink
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Contact
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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
*
No prior experience
Novice
Experienced
Advanced
How you served other Professional Dominatrixes?
*
No
Yes
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
*
Submissive
Masochist
Fetishists
Servant
Painslut
Appointment Information
I acknowledge that I understand NO SEXUAL ACTIVITIES are being offered:
*
Yes
No
Desired Session Date
*
Date Format: MM slash DD slash YYYY
Time
*
:
HH
MM
AM
PM
Desired Session Length
*
1 hour
2 hours
3 hours
4 hours
5+ hours
Extended/Overnight
Explain your extended session desires
Do you have an Alternate Session Date
Yes
No
Alternate Date
Date Format: MM slash DD slash YYYY
Alternate Time
:
HH
MM
AM
PM
Session Details
Session Demeanor
*
Strict
Humiliating
Merciless
Sensual
Teasing
Playful
Sadistic
Interests
*
Please enter your activity interests here.
Pain Level
*
No pain please
Light
Moderate
Heavy
Extreme
Marks
*
No thanks
Light
Lingering (1-2 days)
Long Lasting (3-7 days)
Heavy - i want them to last as long as possible
Marking Limitations
Please list any limitations here
Hard Limits
Please list any hard limits here
Do you have any medical conditions or injuries?
*
No
Yes
Medical Conditions
Please list any medical conditions or injuries here.