Name *

First Name

Last Name

Phone *

(###)

###

####

How do you prefer I contact you?

If email is your preferred method of communication, please make sure there are no typos in your email address and check your spam folder in case my reply goes there

Text

Email

What session(s) are you interested in? *

60 minute FBSM

90 minute FBSM

2 Hour FBSM

4 Hands FBSM

Preferred Date

MM

DD

YYYY

Preferred Time

Hour

Minute

Second

AM PM

At which of my in-call studio locations are you hoping to book your session? *

Denver, Park Hill

North Boulder (requires a 10% travel fee)

Do you acknowledge that you will need to provide ONE of the following in order to book your appointment? *

- A selfie of you holding your driver's license or government ID (picture side out) WITH a separate photo of your license or ID with your first, last name and DOB clearly visible OR - Two provider references (this means: a phone number or email address, link to their professional profile, and please be in touch with them about providing a reference for you)

Yes

Do you acknowledge that I accept cash only, to be donated at the beginning of your session, and deposits via CashApp only? *

Yes

Do you understand that I do not offer full service or add ons? *

Yes

Do you have any symptoms of COVID, cold or flu? *

Yes

No

Have you familiarized yourself with my etiquette preferences? (see "etiquette" at the top of this page) *

Yes