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Dom to Your Door

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I look forward to you serving me!

- Mistress Pasha

Complete and submit the request form prior to your session. Include as much information as possible for the best experience.

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First Name (Required)

Last Name

Slave Name

Email (Required)

Age

City & State

Phone (Use format shown)

OK to Call/Text

How did you find me?

Pro-Domme Experience (Required)

0 - 1 years 1 - 3 years 3 - 5 years 5 - 7 years 7+ years

Which are you?

Masochist Submissive Fetishist Kinkster Crossdresser

Frequency of your sessions:

None Weekly Monthly 2-6 times/year times/year 7+ times/year

Which Mistresses have you served? (Include Name, website and email address):

When was your last session and with which Mistress?

What was your favorite experience to date?

What are your limits? (Required)

Which session dynamic do you respond to best?

Compassionate/Nurturing Tease/Denial No pain Light pain Forced Moderately strict/Moderate pain Sadistic/Torture/Very strict

Can you be marked?

Never A little (Couple of hours) A couple of days As long as it takes I love marks

Which session scenarios interest you?

Mistress/slave Nurse/patient Mother/Aunt Boss/employee Sissy, slut, maid Interrogation/prisoner Other

If other, describe

Which of these do you hope to participate in?

Humiliation acts in private Humiliation acts in public Verbal Humiliation Face slapping Lead on leash Used as a footstool/furniture Other

If other, describe

Sissification/crossdressing:

Panties Garters/Stockings Maid uniform Lingerie Pantyhose Makeup/Wig High heels Innocent Slutty

Discipling/Corporal punishment

Spanking/OTK Wooden paddles/hairbrush Leather paddle Belts/Razor strop Canes Floggers Riding crop Dragon's tail Single tail

Fetishes & Adorations

Leather Latex/rubber Muscle Stockings/garters Heels/shoes Boots Feet/legs Armpit Long nails

Bondage/Sensory deprivation

Bondage - rope Bondage - leather Bondage - latex/rubber/neoprene Moderate Restrictive/inescapable Chastity devices Plastic wrap/vet wrap Mummification Body bag Straight jacket Genital bondage Hoods/gas masks Gags

Sensory Play

Tickling Light touch Blindfolds Headphones/earplugs Pinching Kicking CBT Ball busting/kicking Trampling Hair pulling Sharps, nails, vampire gloves Ice/hot wax Menthol/hot concoction

Medical conditions

Requested appointment

Desired length of appointment

Acceptance (Required)

I have read the policies page and acknowledge my agreement. I understand that my request for an appointment is not confirmed until the deposit is received. See the policies page for deposit amounts.

214-273-9920
214-273-9920
[email protected]
Greater DFW Area

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