Domination Questionnaire

Personal information:

How interested are you in trying:

	Never	Possibly	Yes	Definitely	Yes, please!
General dominance / giving orders

Teasing

"Yes ma'am"

Collar and leash

Bondage (with chains)

Foot / high heel worship

Pet play

Blindfold

Ball gag

Hot wax

	Never	Possibly	Yes	Definitely	Yes, please!
Ice cubes

Wartenberg wheel

Biting

Scratching

Spanking / paddling

Riding crop

Flogging

Nipple torture

Being "forced" to do things

Hair pulling

Feminization

Other interests: (No strap-on, facesitting, or breath play)

Any physical or mental health issues, triggers that should be avoided, safety issues, etc.

I understand that scratches, bruises, or other marks are sometimes a result of these activities and I will accept:

Slight reddening of the skin that will be gone within a few hours

Light marks that can be hidden by clothing (shirt and shorts)

Medium marks / bruises that can be hidden by clothing (shirt and shorts)

I understand that there will absolutely NO nudity or sexual contact of any kind, and that this is not a sexual service.

I Agree