Your Part-Time Girlfriend



Thank you so much for taking the time to fill out my screening form. I cannot wait for us to get to know one another!

* Same day incalls for Manhattan must be requested with at least five hours notice

* Same day outcall requests require at least four hours notice.


* Incalls requested for NJ or CT require 24 hours notice.

* Please keep these booking requirements in mind when attempting to schedule a session with me.  

* Please do not complete this form without thoroughly reading the Etiquette portion of my website.


Thank you so much for your patience and understanding.



Screening Method (Select One)

Screening is necessary in order to establish my safety and comfort before meeting. This is not optional. Please assure that you provide proper photo verification with the requirements listed.

Please provide a photo :

                     * DO NOT PUT A SELFIE AS VERIFICATION *



                          For Outcall Verification :

The only verification that I require for outcalls to private residences is a photo of you holding a piece of mail reflecting your Full Name and the Full address in which our appointment will take place. This must match the information provided above and you and the mail must be visible in the picture.





                         For Incall Verification :

(Or outcalls to hotels )

For Incall Verification I simply require a photo of you holding some form of documentation confirming your Full Name/Identity. This could be an ID/ Piece of Mail/ Piece of paper with your LinkedIn or Facebook URL etc.




- 1)  Valid ID/Drivers License/ Passport : holding your ID / Drivers License/Passport , I simply need to see your photo and full first and last name. You may cover up or blur all other identifying information. I must clearly be able to see you and your ID/Drivers License/Passport or Work Badge in the photo.



 - 2)  LinkedIn : holding your LinkedIn url and full name on a piece of paper. Your LinkedIn must have a verifiable profile picture and multiple connections. I must be able to clearly see you and the piece of paper to properly match your identity to your LinkedIn.



-  3)  Social Media (Facebook Or Instagram) : holding a piece of paper showng your full name and Social Media handle. This profile must be public. You must have photos of yourself on the platform and it must reflect your name and evidently be you. I will be cross referencing the photo you send of yourself with the Social media accounts photos.



- 4) Two Verifying Documents : holding two verifying documents that reflects your full first and last name.  This could be (pieces of mail, diploma, awards, letter, statement, etc) You may blur out any other identifying information, however I must visibly see your full name on both documents. You must be holding the verifying document in the pictures. 

* Please make sure that you and the information that I require is clear and legible in the photos provided. The information must match what you have provided above.

Upload File
Upload File

* If you are verifying through Linkedin, Facebook or Instagram please provide the direct link here*

Deposit Method*

A $100 deposit is required to confirm all sessions.
Polite Introduction

Please be aware that all of the information provided on this form will be thoroughly checked and researched to assure that you are a safe client for me to see, Improperly filling out this form in any way, shape, or form will result in your application automatically being discarded. 

In conclusion, I can be discreet with you but you can not be anonymous with me. If you are uncomfortable with the provisions that I have in place, please feel free to see another provider. I prioritize my safety and freedom above all else. Thank you.

Thanks for submitting! Please check the email pr phone number that you have provided for a response.