PLEASE COPY AND PRINT THIS PAGE HERE and send to me by e-mail prior to any booking.

This enables me to know  what boundries to respect as each individual has different attitudes towards their own sexuality.

When filling out this form please try to be as liberal and free minded as you can so that you fully benefit from the experience.

Do you have any sensitive or ticklish areas that you prefer not touched? _________________

Are you happy to receive the VERY sensual side on massage __________________

Sometimes during the more intimate parts of a massage  a masseur can acquire an erection. Would this offend you?________________________

Would you like the Yoni Massage?_______________________

Which of the following erogenous zones are you happy to be touched?
indicate with a tick for Yes or a Cross for No

Face______________
Mouth_________________
Breast___________________
Buttocks or bottom__________________
Anus (usually just gentle probing with pinky during Yoni massage)_________________
Yoni ____________________

Would you be happy for the masseur to use the following during the massage?
indicate with a tick for Yes or a Cross for No

Hands_______________
Body__________________
Mouth ____________________
Tongue________________________

Where did you hear about this ________________________________________

Please copy this and paste on to word block or Word or directly on to an e-mail and send it to me at the address above.