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Please copy and paste into your email to me at Empressm07@aol.com or Goddess J

Please fill out this questionnaire completely.

This questionnaire is to get to know you better and make your session more fulfilling.
Name:


 Email Address:


Phone Number:

Day and time you wish to session with me



 How can I contact you if I need to
 

 What town do you live in?


Marital Status

Sexuality:

Any  Health Problems and/or Phobias? (Explain fully)


What Type of Training do you desire?


 Do you  like the psychological aspect of BDSM?
 

Why? (Please explain fully)


How do you envision your mistress?

Answer yes or no to these questions
What type of submissive or fetishist are you?
 Someone who

Some one who needs to be disciplined and controlled
 Some one wants to surpass your limits and submit totally
 Some one who is an service oriented submissive
 Some one who dose not enjoy pain but enjoys strict control and humiliation
 Some one made to obey by force
Some one who needs to be sexuality controlled completely

What are your thoughts on ongoing training ?

 How often do you session?

 Tell me about your last session. What you liked? And what you did not like about it?


Would you like to serve more than one Mistress

Are you interested in a Master in your session along with the Mistress?

Would you serve with other Submissives?


What are your hard limits, soft limits?


Would you be in videos pictures and on the website if asked


What do you want to tell me about you that would make our session the best you can have?


 Where did you see my site, and why did you choose me to session with?

Any interest in personal servitude or 24/7 slavery? tell me your thoughts.

Abrasion:
Age Play:
Anal Sex:
Arm/Leg Sleeves:
Asphyxiation (breath play): 
Beating hard:
Beating soft:
Begging/Pleading:
Biting:
Blindfolds:
Bondage (heavy):
Bondage (light):
Boot Worship:
Branding:
Breast bondage:
Breast Whipping:
Brown Showers/Scat (feces play):
Caning:
Catheterization:
Chauffeuring:
Chastity:
Choking:
Chosen Clothing for:
Chosen Food For:
Clothespins:
Cock Worship:
Collars (wearing):  
Corsets (wearing):
Cross Dressing:
Cutting:
Daddy Play:
Dilation:
Double Penetration:
Electricity:
Enemas:
Examinations (physical):
Exhibitionism:
Face Slapping:
Fantasy Gang Rape:
Fantasy Rape:
Fisting:
Flogging:
Following Orders:
Foot Worship:
Forced Dressing:
Forced Homosexuality:
Forced Masturbation:
Forced Nudity:  
Forced Servitude:
Full Head Hoods:
Gags:
Genital Sex:
Given Away:
Golden Showers (piss play):
Hair Pulling:
Hairbrushes:
Handcuffs (metal):
Harnessing:
High Heel Worship:
Homage With Tongue:
Hot Waxing:
Housework:
Human Pony:
Human Puppy:
Humiliation In Private:
Humiliation In Public:
Ice Cubes:
Including Others:
Infantilism:
Interrogations:
Intricate Rope Bondage:
Kidnapping:
Kneeling:
Latex Clothing:
Leather Clothing:
Leather Restraints:
Lecturing:
Licking:
Massage(giving):
Medical Scenes:
Mommy Play:
Mouth Bits:
 Mummification:
Nipple Torture: 
Oral Anal Play:
Orgasm Control:
Orgasm Denial:
Over-the-Knee Spanking:
Phone Sex:
Piercing (perm):
Piercing (temp):
Pussy Whipping:
 Worship:
Religious Scenes:
Riding Crops:
Rubber:
Scratching:
Sensory Deprivation:
Serving as Ashtray:
Serving as Furniture:
Serving as Maid:
Serving Orally:
Serving:
Sexual Deprivation:
Shaving:
Spanking:
Speculums
Spreader Bars:
Stocks:
Straight Jacket:
Strap-on Dildos:
Suspension (inverted):
Suspension:
Tape Gags:
Teasing:
Tickling:
Uniforms:
Verbal Humiliation:
Video Scenes:
Voyeurism:
Whipping
Wrestling:


Limits - Are there any specific scene-related things you will not do?

Fetishes - Are there any specific scene-related things that you really like?