NEW SUBMISSIVeintake form SESSION APPLICATION AND SUBMISSIVE INTAKE Name * First Name Last Name Phone * (###) ### #### Email * Preferred Contact Method * Text Email Age * Preferred Pronouns * Gender Identity * City * Have you ever served another professional Dominatrix? * Yes No Previous Experience Yes, but as a lifestyle/service sub Provider References Please check in with any other providers you'd like to give as references before giving their name or contact information. What is your level of lifestyle experience * No previous experience Beginner Intermediate Seasoned player 24/7 Lifestyle How would you describe your Lifestyle Alignment? * Please check all that apply Submissive Sissy Fetishist Masochist Servant Worshipper Little Pet Unsure/Wanting to Explore APPOINTMENT INFORMATION I acknowledge and agree that NO SEXUAL ACTIVITIES OR SERVICES are being offered. * Yes, Goddex. I understand. No, but I will not waste your time. I acknowledge that I will be asked to provide identification to verify that I am of legal age and that I will be screened for safety prior to being considered for a session with Goddex Vicious. * I will not provide identification Yes, I would be happy to prove that I am safe and of legal age IRL or Virtual Session? * Realtime In Dungeon Cashmeet In Public Virtual Session Via Skype Virtual Session Via Zoom Desired Session Date * Goddex's preferred availability is Tues, Wed, Fri, Sat and Sun from 2pm-9pm PST. Inquiries must be made no less than 24hrs to desired appointment time. More is STRONGLY preferred. MM DD YYYY Desired Session Time * Please select your desired session time slot. 2pm PST 3pm PST 4pm PST 5pm PST 6pm PST 7pm PST 8pm PST 9pm PST Desired Session Duration Please select the length of the session you would like to book. Multiple hour bookings are more economoical. Half Hour (VIRTUAL SESSIONS ONLY) One Hour Two Hours Three Hours Session Type * Check all that apply Humiliation Discipline and Corporal Punishment Body Worship Pet Play Diaper play, CG/l roleplay Financial Domination Cashmeet Fantasy Roleplay Sissification/Transformation Pure Service (cleaning, chores) Hypno/Brainwash With Visualizations Shopping date Session Temperament * Check all that apply Sadistic Sensual Strict Merciless Nurturing Soft Teasing Humiliating Affirming Casual Playful Session Activities * Check all that apply Hair Pulling Choking Spanking Caging Bondage (light) Bondage (heavy) Domestic Service Financial Domination Slapping Ageplay and Infantilization Humiliation FootWorship AssWorship Watersports Restraints Forniphilia (Human Furniture) Forced Intox (herb and fungi ONLY) Needle/Bloodplay (must show test results and PREP) Sissification Pet Play Sensory Play Wax Play Tease and Denial Orgsm Control/Ruining Chastity Kneeling/Crawling Water Torture/Waterboarding Sensory Deprivation Sensory Bombardment TECHDOMME BRAINWASH WITH CUSTOM VISUALS Boot and Show Worship Breathplay Electroplay OTK Mummification Spit Do you have any interests, desires or goals for O/our time together that are not listed above? remember, no sexual activity or services. Desired Pain Level * No pain whatsoever Light Moderate Heavy Extreme Marks? * No Discrete, or specific areas only Yes please, make me Your canvas Goddex Medical Conditions * Please think very carefully and list any and all medical conditions such as allergies, physical limitations, mobility restrictions, chonic pain points, chronic conditions, positions to be avoided Psychological Triggers * Please think carefully and list any and all psychological trigger words, scenarios, activities, names, phrases, sounds, and actions that Goddex should be made aware of. SAFE WORD POLICY * I affirm that I understand that the house safe words are YELLOW and RED. Saying YELLOW is like hitting pause, and will prompt a check in to discuss changing positions, intensity, etc. RED will prompt a full stop to the scene, immediate release from any predicament, and a shift into providing care and support, be it physical or psychological. Alternative prompts will be given in situations where gags, immobilization, etc prevent words from being spoken. No, I need help to understand what this means prior to our session. Yes, I have read and understand. BOOKING, DEPOSIT, AND CANCELLATION POLICY * * All sessions are booked at least 24 hrs in advance. There are no last minute or same day bookings. * 25% NONREFUNDABLE session deposit is due at time of booking. The deposit secures your time slot. The session is not booked until the deposit is paid. *24 hrs prior to our session, Goddex will check in with you via the preferred contact method stated above and confirm your appointment. *Cancellations cause undue hardship. Stick to your appointment time. In the event of an emergency or scheduling conflict, client is permitted ONE and ONLY ONE cancellation and reschedule provided that this cancellation is made more than 24 hrs in advance. Rescheduling is done at Goddex's sole discretion and convenience. *A second cancellation, or any no call/no show is immediate grounds for block and dismissal. No, I have further questions and I would like to be contacted for clarification. Yes Goddex, I understand and agree. AGAIN, I UNDERSTAND THAT NO SEXUAL ACTIVITY IS BEING OFFERED AND THAT I WILL BE ASKED TO SCREEN FOR SAFETY WITH MY IDENTIFICATION * No, I won't waste Your time Goddex. Yes, Goddex, I understand INITIAL TRIBUTE POLICY * Goddex Vicious requires an initial tribute to consider applications from every new submissive. Your application will be IMMEDIATELY DECLINED if it is not accompanied by an Initial Tribute of $50 or more. Sending initial tribute demonstrates to Goddex that you are a serious potential submissive. Tribute communicates consideration for Her time and energy during the booking process and establishes that you have the resources necessary to indulge in luxury experiences with a Pro Domme. Most importantly, initial tribute proves that you are not attempting to steal Goddex's valuable time and attention by extracting pleasure from this interaction without any intention to book a session or have a meet. Upon completion of this form, you will be redirected to a landing page that contains links to Goddex's preferred payment methods. Once your session application is submitted and your initial tribute is received, Goddex will review your application and reach out to you through the preferred method of contact you have chosen above. Yes, Goddex. I have read and understood the initiral tribute policy and I am ready to submit my application with an initial tribute. No Goddex, please disregard My application. I am only here to waste time. Thank you!
