Text 626.225.2421 | TheDominatrixLA@gmail.com | Instagram: @DominatrixLA

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* 1. Full Name:

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* 2. Age (18+ only, verification may be required):

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* 3. Cell (accepts texts):

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* 4. I'm interested in:

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* 5. My general area is:

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* 6. I'm:

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* 7. My experience level is:

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* 8. The following kinks interest me:

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* 9. 1. I understand Mistress does NOT offer sexual services, pegging or strapon, full toilet training, oral sex, or anything ending in "job".

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* 10. I like to be called:

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* 11. On a scale of 1 (Ouch! I don't like any pain) to 10 (Bring it on! I'm a total pain slut), I consider my pain tolerance to be?

1 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 12. I would like Mistress to leave marks on my body to help me remember my session with her:

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* 13. My favorite bdsm related fantasy/scenario:

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* 14. Hard limits/additional information I would like Mistress to know prior to my session with her, including any relevant physical, medical, or emotional limitations, or other concerns:

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* 15. I found Mistress on:

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* 16. I'm ready to have some fun! 😈

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