Client Intake Form

You have been directed to this page because we have an appointment booked soon. If you have not filled out this form in the last year, please take a moment to fill it out and update me of any new or changing interests or health concerns.

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Name and pronouns *

Email *

Phone Number

Where are we meetings?Portland OregonBoston MAColumbus OhioDestin FloridaVirtualOther

How do you identify?DominantSubmissiveSwitchNot Sure Yes

What do you hope to achieve from your time with me? *

Do you have any health concerns I should be aware of? Knowing your health issues and concerns will help me push your limits, while respecting your well-being. Please list any physical ailments as well as any medications you take that may affect our play. *

Please give me a brief history of your BDSM experience. *

How do you like to feel when you play? *

What activities are you interested in exploring? *

Are there activities that scare you, but that you might be interested in experiencing if the situation was right? *

Have you ever had a bad or less-than-fulfilling BDSM experience? If so, please describe. *

Any other requests for our time together?

In submitting this form, I affirm that I have answered these questions to the best of my ability and that Princessa will use this information to push my limits and expand my self awareness of my individual kinks and fetishes. I understand that Princessa Natasha Strange offers a variety of BDSM services, but no sexual services. Any requests for sex or nudity will be met with my immediate and permanent dismissal. I understand this is Princessa's personal limit and not simply a legal disclaimer. *

• Yes, Princessa

Submit