Screening

Please complete the screening form in its entirety. 

My screening methods are non negotiable so please DO NOT proceed in contacting me any further if you do not wish to fully oblige. 

I only see men between 25 and 70. I do not see women nor couples.

    First AND Last Name:

    Age:

    Phone Number (No VoIP):

    Email:

    City and State Where You Live:

    Proposed Date & Time:

    Meeting Duration (Choose From Drop Down List):

    Outcall Location (No Incall):

    Message: