Screening Form 1: The Experienced Version

General Instructions & Information:

Please answer all the questions completely. Failure to do so will only prolong your wait time and result in a request for additional information.

After your forms’ submission, your responses will be Reviewed and Verified. This is never an instantaneous process and can take up to 72 hours to complete.

If you are seeking a Same-Day Session (a session that takes place on the same day as you submitted the Screening and Scheduling Form), please complete the form and send a text to 480-269-5344. There is no guarantee that your request will be accommodated.

Be Prepared Before You Start!

Start off Prepared by having on hand any information you will need to complete the form. To assist you in preparing I have compiled a list (below) of what you will need to complete the form.

Having everything ready will help ensure that you are able to fill out the form quickly, easily and completely!

What You Will Need: 

Your answers on the Screening Page indicated that you are an Experienced Potential New Client, which means that you hold Memberships with either Preferred 411 and/or The Erotic Review and/or you have met with an Adult Entertainer (Escort or Dominatrix)  or two or more, at some point in your life. The Experienced Version of the Screening Form will request your Membership Information and/or information regarding the Entertainers you have previously met with, known as Escort References


If you hold Memberships then you will need your Member ID #’s. For Example Mine are:

Preferred 411: P116705

The Erotic Review: 155745

If you have previously met with any Adult Entertainers (Dominatrixes and/or Escorts) please see the following box for information on Escort References and a list of what you will need to provide.  

Escort References

If you have met with Erotic Entertainers/Dominatrixes in the past you will need to provide at least one of them as an ESCORT REFERENCE. Because Entertainers/Escorts are known to leave the business without notice, it is best to provide at least two Escort References.

Your Escort References can be from anywhere in the United States, as long as I am able to easily locate them online (on Escort Advertising Websites, such as Eros, or Escort Review Websites, such as The Erotic Review).

Escort References given for the purpose of Screening Potential Clients is an extremely common practice, one that any established, professional escort will be aware of and willing to cooperate with. Escort Reference Verification is the best way for Adult/Erotic Entertainers to keep themselves and each other safe!

You need not worry that giving out your escorts information will offend her or cause her to be upset with you. All established, professional escorts are aware that their clients, even their regular clients, could and often do, seek out the services of other escorts. Variety is the Spice of Life!      

Information needed to provide Escort References:

  • The Escorts STAGE NAME (the name she goes by in her ads and reviews).
  • The Escorts CONTACT INFORMATION (her Phone # and/or her e-mail address; whenever possible please provide both).
  • The link to her PERSONAL WEBSITE, where she promotes her escort services.
  • The link to one of her ONLINE ADVERTISEMENTS. Whenever possible this link should not be to an ad on
  • The link to her REVIEWS on  or other Escort Review site.
  • YOUR NAME: The name you used when contacting her.
  • YOUR CONTACT INFORMATION: The phone number and/or e-mail address you used when contacting her.
  • The CITY/STATE you met your Escort Reference in.
  • The APPROXIMATE DATE you met with her.
  • WHERE you met with her (at your place or hers/private residence or hotel).
  • Any ADDITIONAL DETAILS you believe will assist your Escort Reference with recalling you.

Please Note: I will not accept references from Escorts that are only listed on and have no reviews on any Escort Review website.

Before an escort can be contacted to act as a reference, I must first be verify that she is ESTABLISHED AND ACTIVE. To be ESTABLISHED an escort must be easily located on the Internet through her advertisements, reviews and/or her personal website. To be an ACTIVE ESCORT means that she is currently and actively advertising her services and has not left the Adult Industry.

Once it is determined that your Escort Reference is Established and Active, she will be contacted and asked three simple questions.

  1. Has she met you?
  2. Would she be willing to meet with you again?
  3. Are you, in her opinion, safe for me to see? 

If the escort answers are “YES” to all three questions then she has given you a POSITIVE REFERENCE and you will be able to schedule a session with me.

If the escort answers “NO” to any of the three questions then she has given you a NEGATIVE REFERENCE and you will not be able to schedule a session with me.


The more information you provide

the more likely you are to be approved for a session. 


Same Day Sessions: 

If you were hoping for a Same-Day Session (a session that takes place on the same day as you fill out this form), please complete the form and then send a text to 480-269-5344. I cannot guarantee that I will be able to accommodate your request but I will try.

Screening Status 

You will receive your SCREENING STATUS via text or email, after I review and verify the information submitted:

  • APPROVED: You are eligible to schedule a session with me.
  • IN PROGRESS: This status is always accompanied by a request for additional information or clarification on information previously provided.
  • DENIED: You are not eligible for a session with me. This is a permanent decision and is irreversible. If your status is ‘DENIED’, I suggest accepting it as a fact and moving on.


If you receive notice that you are approved you may either complete the Scheduling Form or contact me to schedule your session.


Should you have any questions regarding the completion of the form or need assistance to complete it, please contact me at or submit your question using the Questions, Comments and Suggestions Form

Thank you!

Thank you for your interest and for your cooperation with my Screening Process! I will do my best to get you approved within 48-72 hours after I receive your completed form.