Session Questionnaire

New and returning visitors, welcome. You’ve read, how to be a quality visitorknow your interests and have a session date in mind, you may book your appointment by submitting this session questionnaire. If a new visitor, please send required, $100 deposit via, Square Up  to secure your appointment. I look forward to meeting you! ~ Mistress Victoria

Please note, New Visitor applications, sent without a deposit, are deleted.

Your first name (REQUIRED)

Your last name (REQUIRED)

Your sub/slave name

Your email (REQUIRED)

Would you like to be added to My private newsletter?
Yes, thank you!No, thank you

Your age
21-3132-3940-4950-5960+

City and state

Your telephone number (REQUIRED)

Is it Ok to call you and/or, leave a discreet voicemail on this number?
yesno

How did you find Me? (if internet search, please tell the words, you used)

Which are you (mark all that apply)

Your Prodomme session experience is

Your Prodomme session experience spans

You session with a Mistress

Which Mistresses have you served? (REQUIRED)

When was your last session & with who? (REQUIRED)

Any UNFAVORABLE experiences, Mistress should know about?

Which theme room/s, are you hoping to experience?

Can you be marked?

What are your limits: (list your off limits)

Which session dynamic/s, do you favor?

Which D/s scene/s interest you?

Why are you requesting a visit with Victoria Hunter, what are you hoping to experience?

Which of these, do you hope to participate in?

Humiliation & Submissive Control (mark all that apply)

Crossdressing & Sissification (mark all that apply)

Medical Fetish Play (mark all that apply)

Discipline & Corporal Punishment (mark all that apply)

Bondage & Mummification (mark all that apply)

Sensory & Deprivation (mark all that apply)

Fetishes & Adorations (mark all that apply)

HEALTH; participating in a session involving BDSM activities can put stress on the body. Disclose any medical conditions that could lead to problems during a session. Heart conditions, chest pain, fainting spells, dizziness or high blood pressure, particularly if induced by stress. Pacemakers and other surgically implanted medical devices. If diabetic, which type. Asthma, respiratory or breathing issues. If claustrophobic. Muscular and skeletal issues, particularly back and knee. Allergies to latex. A contact lens wearer. It is your responsibility to disclose these.

Are you in good health?

I would like to make an appointment with Mistress Victoria on the following date

I would like to have my appointment with Mistress Victoria at this time

Appointment length requested

INFORMED CONSENT STATEMENT; I am requesting and at my own risk participating in a BDSM session (the Session). I understand activities within the Session will be conducted by mutual consent. I accept sole responsibility to; (a) decide what activities I wish to participate in during the Session and decide what my boundaries are. (b) communicate these decisions clearly before the start of the Session. (c) agree to an appropriate safe word or other signal to request an activity stop. (d) signal immediately, any unexpected fatigue, shortness of breath, chest discomfort, nausea, pain or discomfort. I understand I can discontinue participation at any time during the Session, without prejudice against me, beyond fees or tribute for the Session. LIMITS OF LIABILITY; I understand that any activity undertaken during the Session are voluntary and are at my own risk. I agree to indemnify and hold harmless all participants in the Session from all claims of liability, injury, death, property loss or damage, attorney’s fees and costs and I agree to reimburse them for any such claims; of same, they may have.

AGREEMENT; by checking the box and submitting this session application, I acknowledge I have read, understood and agree to the contents of this form and I confirm that all information given by me, is correct to the best of my knowledge. I understand there is no sex involved in Mistress Victoria's sessions, I'am a consenting adult over the age of 21 and I am not a law enforcement officer or federal law enforcement agent.

CANCELLATION POLICY; by checking the box and submitting this session application, I acknowledge I have read, understand and agree to Mistress Victoria's Cancellation Policy.