Real name:

Address:

Phone number:

Place of Employment:

Work Number:

Car make, model, year and color:

Currently involved with someone else: 
 If yes: does that person know about outside activities
 If Yes: Can I speak with that person
 

Is a safe call decided on:
 If yes: have they been provided with name of meeting place and times
 If yes: Have they been given a good description or picture of the person you are meeting
 If Yes: has a word for "help me" been decided on
 If yes: has a word for "everything is fine" been decided on
 If yes: has a plan of action in case of a problem been worked out

Has a safeword been issued:

Will play be expected:
 If yes: what types of play
 if yes: what limits will apply

What kinds of play are you willing to participate in:

Have safe sex practices been discussed:

Will condoms be used:

Has a play list been exchanged:

Has a scene negotiation form been exchanged:

How do they view submission/domination:

How do they view the opposite gender

Do they prefer a submissive, slave or bottom

Do they prefer a dominant or a top

Will pain play be expected

what is expected of the sub/dom

Has health been discussed
 if yes: any health concerns
 if yes: any specific medical conditions to be worried about

How much experience does the person have:

What is the person's favorite color:

Are they open about their real lives and experiences:

Do they willingly provide answers to questions

Do they support any efforts to seek more information

Do they want a relationship or just a play partner:

Have they had prior doms or subs:

How do they handle punishment:

What do they consider to be abusive:

What do they consider to be consent:

What ways are they providing for their own safety and yours:

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