Appointment Application

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INSTRUCTIONS: Copy and paste this form into an email to Me at stellinaobscura@proton.me. Complete ALL responses and send. 

Name and last initial:

When are you requesting an audience with your Goddess? (My days off are Tuesday and Thursday)
Date:
Time:
Duration:

Age:

Physical Description:

Marital Status:
Sexual Orientation:  

Financial Status and Employment Industry:

Medical Concerns/ Physical Limitations:

Surgeries (Within the last 3 years):

Phobias/Abuse/Trauma Issues:

Can you be marked? If so, for how long?

How often do you wish to visit with Me? Weekly? Bi-Weekly? Monthly? Biannually?

Do you have any attire requests for My wardrobe? (fetish clothing, accessories, or shoes)

How long have you been involved in BDSM activities? (Professional/ Personal)

Is this your first time visiting Atlanta Dungeon?

Do you have references from other Professional Dommes? (local, national, or international)

Do you have any other skills outside slavery that you can offer Me? How will you please your Goddess other than Her required tribute?

ACTIVITIES I AM INTERESTED IN: (please choose all that APPLY and delete those that DONT APPLY)

1. Bondage: Leather, Rope, Bondage tape, Saran wrap
  Bondage Level: Light, Inescapable, Extended, Mummification

2. Corporal Punishment: Flogging, Whipping, Spanking, Caning, Paddling, OTK

3. Genital Torment: Kicking/Kneeing, Trampling, Vise, Stretching, Weights, Bondage, Manual Squeezing

4. Foot Worship: Stocking/Pantyhose, Shoe/Boot/Heel, Bare Feet
Method: Bootlicker, Toe Kisser, Masseuse, Footstool, Rug

5. Humiliation: SPH, Diapering, Cuckholding Fantasy (Verbal ONLY), Sploshing, Toilet Training, F-Bi Fantasy (Verbal ONLY),
  Other (Please describe here):

6. Domestic Service Training: Maid, Chauffeur, Foot slave, Errand boy, Wine & Charcuterie

7. Feminization: Dress up, Shaving, Makeup, Crossdressing, Public Play, Strap-on Fanstasy

8. Puppy Training: Caging, Water bowl & Dog Food Consumption, Leash Training, Verbal Command Training

10. Financial slave/Paypig

12. Chastity/Key-Holding. If yes, then how long?
     Duration: Long term/ Short term /Session only
     Do you own a chastity device? Describe it here:

13. Medical Play: Electrical, Urethral Sounds, Anal Play, Physical Exams

14. Roleplay interests: Nurse, Massage Therapist, Mommy, Teacher/Principal, Mean Girl/Bully

15.  Is there a specific role-play scenario you are seeking? Please describe:

16. Where did you find Me?
 

 *All information provided is confidential.

DISCLAIMER: I do not provide illegal or sexual services. Please review the list of specialties above. No sexual acts offered. ONLY fantasy play!