By completing and submitting this form, you are agreeing to all my policies on my RATES page. Screening plays an important role in confirming your time with me. Please be sure to fill out the form completely. I do verify the information submitted so please double check your responses. Your information will be kept confidential and will be discarded immediately after verification. Please understand that this process is for my safety and any haggling will result in termination of contact. Thank you! XOXO