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Screening Form (USA)

All new visitors must schedule 24 hours in advance and is expected to fill out my Screening Form for scheduling. Once I’ve properly screened you I will contact you to confirm your appointment. You may send me a follow-up e-mail when you have completed the form.

If we have met before, you can send me an e-mail and outline the appointment details (such as the requested date, time, duration, and location).


General Information










Age Verification

Appointment Details







How do you wish to pay the deposit?




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