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Questionnaire
PLEASE NOTE: Twenty-four hour notice required for all appointments. Appointments booked more than 24 hours in advance require a 50% deposit. No appointments accepted without submission of this completed form. Where not applicable, simply leave blank. If you have problems with this form please contact us at adminsupport(@ symbol)goddesssonya.com


Name
Email Address
Occupation
How did you find out about me?
If other please specify
Marital Status
If single are you attached?
Age Group
Experience
Years of Experience

Describe yourself ( Multiple items may be selected )




Sexual Orientation

List any conditions or injuries (past or present) that may preclude session activities:(Inlcude phobias, surgeries, sports injuries, diseases)


List any hard limits:
(i.e. Activities that you would absolutely never consider doing under any circumstances):

Is Marking Permitted?

Specify any limits:


Safe Word

List main interests:


Wardrobe request:


Rate your interest in the following activities
Very Interested, Somewhat Interested, Not Interested

Punishment

Single Tail
Spanking
Paddle(leather)
Paddle(wood)
Belt
OTK
Flogging
Caning
Whip
Riding Crop


Bondage

Rope
Restraints
Gags
Genitals
Cuffs
Spreaders
Suspension
Breasts
Sleeves
PlasticWrap



Torture/Teasing

T&D
Chastity
Hair Pulling
Nipples
Clothespins
Hot Wax
Ball busting
Genitals
Breath Play


Humiliation

Spitting
Foot-worship
Kneeling
Crawling
Leash
Verbal Abuse
Face slapping
Forced fem
Forced bi
Public


Sensory Deprivation

Blindfolds
Hoods
Ear Plugs


Other Activities

GS
BS
DT
Fisting
Enema
Body Worship


Any additional comments


Disclaimer
I understand the information I provide is strictly confidential and that Goddess Sonya does not provide sexual services, only BDSM & Roleplay services. By submitting this form, I release Goddess Sonya from any liability and agree that anything done to me as a result of this information is consensual and strictly for entertainment purposes. I further agree that I am over 21 years old and have answered all questions honestly and openly.

Please check this box to accept the terms and conditions above before submitting this form

 


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