YEE Intake Form - Start Your Journey in Oakland FBSM INTAKE FORM Leave this field blank First and last name Preferred phone number Country code + Phone number Can a voice mail be comfortably left for you at this number? (optional) Yes Absolutely not Other Please explain here (optional) Email address Are you local to the Bay Area or from out of town? Yes, I live in the Bay Area. No, and this is my first time visiting the Bay Area. No, I’m from out of town and rarely visit the area. No, I’m from out of town and visit with some frequency. Age Occupation (optional) How did you find me? Google Search Bondassage.com Eros.com Private Delights Tryst Referral Other Session Information: Please choose your preferred session. Milking Table Session Soft Touch Session // Energetic Erotic Blueprint Prince Session // Sensual Erotic Blueprint King Session // Sexual Erotic Blueprint Bondassage // Kinky Erotic Blueprint Elysium // Shape Shifter Erotic Blueprint Coaching Bondassage Training for Couples Length of Time 60 minutes 75 mins (Luxury Milking Table session ONLY!) 90 minutes 2 hours 2.5 hour Luxury session (spa + massage experience) 3 hour Your "Erotic Evolution" package (coaching + massage) Duration (if longer than 2 hours) (optional) Preferred day/time/window of opportunity for session: Please note: My usual availability is Mon-Thurs 12pm-6pm. Due to scheduling considerations at my work space, I'll need to add $100 to donation for sessions that must begin before 12pm, at or after 6pm, or on weekends (Friday, Saturday or Sunday). Some exceptions may apply. Some other possible dates/times that would work for you: What is inspiring you to have a session with me? Please provide details about your preferred session. (optional) (Optional but important to me) How would you define what it means to be erotically intelligent? (optional) (Optional but important to me) What would you living into your erotic evolution look like at this stage/phase in your life? (optional) Provider References (optional) Provider references are my preferred form of screening, however there are other options available. If you do not have a current (within the past 12 months) provider reference, please see alternative options below the Reference section. Reference #1 - Your provider reference's name (optional) Her email address (optional) Her phone number (optional) Country code + Phone number Her website or link to her online ad (optional) https:// When did you see her? (optional) What city did you see her in? (optional) Something specific to help her remember you? (optional) Reference #2 - Your provider reference's name (optional) Her email address (optional) Her phone number (optional) Country code + Phone number Her website or link to her online ad (optional) https:// When did you see her? (optional) Something specific to help her remember you? (optional) If you do not have provider references, you may provide one or more of the following as an alternative method for screening. I will accept these at my discretion to screen you. (optional) Your personal website (I prefer it include a photo and bio of you. If you submit a website, I ask you to also include another of the following options as well.) (optional) https:// Your Linked-In Profile (optional) https:// Your Facebook Profile (optional) https:// An office phone number to a receptionist who can forward a call to you. (optional) Country code + Phone number Service Agreement (optional) With reference to CA Penal Code section 647(b), CALJIC No. 16.420 and all pertinent codes and laws in the area where we will be meeting, the services discussed herein do not in any way include or relate to either: (1) engagement in any lewd act for money or other consideration, or (2) Solicitation, offer, or agreement to engage in any lewd act for money or other consideration. I understand and agree to the above statement Cancellation and Re-scheduling Policy (optional) An appointment for pleasure is still a business appointment. I require 24-hours notice by phone (as well as by email) for any cancellations or re-scheduling of sessions. If less than 24-hours is given (without a specific and sensible reason that is acceptable to me), I reserve the right to refuse to see a client in the future unless (by my discretion) 50% of the missed session is paid prior to scheduling a future session and/or a future session is pre-paid in full, and will be non-refundable if the session is missed. Similarly, if a client is a no-show/no-call and does not call to explain the reason within 12-hours of the session time, the client will automatically be black-listed and all relevant contact information will be posted to the appropriate lists, forums, and websites for unreliable clients as well as to my Preferred Referral Network of providers. In conclusion, be considerate. That way everyone has a good time! I have read and understand the cancellation/re-schedule/no-show policy Subscribe to my monthly newsletter for $100 OFF your first session plus interesting writing and other offerings and specials. Sign up at this link and email the discount code to yesplease@youreroticevolution.com to redeem: https://bit.ly/NewsletterSpecialOfferForYou No, not at this time. Would you like to be on my locals "last minute specials" mailing list? If you live in the SF Bay Area, you're invited to be on my (very!) discreet locals mailing list. This privileges you to being notified when I have weekly and same-day appointment openings if you like to be spontaneous! Yes, I'd love to be on your locals "last minute specials" mailing list. No thanks. No thanks. I'm unfortunately not a local. I understand that in-call sessions that need to begin before 12pm, after 6pm, or on weekends (Fridays, Saturdays or Sundays) may have an additional $100 "convenience fee" added to them. Yes I am aware that Lady Claire's workspace is located in Oakland, Ca, in the San Francisco Bay Area. Yes Before our session... (optional) For the most outstanding experience during our session, I recommend you go to this website: https://bit.ly/EBQuickieQuiz Complete this brief quiz, then email me your results: claire@youreroticevolution.com This is completely optional; however it will give me some very valuable information to help enhance our session. Thanks so much! Send