contacting me

New clients: Please use the booking form below to supply screening information and details about the type of appointment you'd like to book. After I receive your initial screening form, I will contact you via email to schedule an appointment.

Returning clients: Please use this form to contact me. 

Initial screening form

Name *
Please supply your full legal name, as it appears on your photo ID. Include your middle initial in the first name field.
Date of Birth *
Date of Birth
Enter your date of birth.
Identification upload
Click on the upload button above. Please upload a clear image of your government-issued identification.
Photograph upload
Click on the upload button above. Please upload a clear, recent photo of yourself from the shoulders up.
Phone *
List your cell phone or home phone number. Do not list unregistered, private or virtual phone numbers.
Tell me a little about yourself! A brief biography, why you decided to contact me, local restaurants you like are all things I'd love to learn
Employment Verification
Give your employer/company name
Please provide your employer's physical address
List your employer's general telephone number
Please provide your position or job title
Work Phone Number *
Work Phone Number
Provide your personal work phone number or extension
Provide your LinkdIn profile, if you have one
Please provide the names, websites and contact information for at least two independent providers that you've seen in the last year. Include the date(s) that you saw them.
Appointment details
Please select the length of appointment you would like to book. If you are located outside of NC, please select the 'Travel' option.
Please include any detail about what you would like to include in the appointment time, such as: events to attend, dinner reservations, spa trips etc DO NOT include any sexually explicit or suggestive details here.
Please indicate whether you would prefer incall or outcall. Please note that outcalls involving a certain travel time may incur a small fee.
Date *
Please indicate your preferred appointment date
Time *
Please indicate your preferred appointment time
Have you read and understood the Etiquette, Rates and F.A.Q. pages before contacting me via this form? *