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Schedule Me

Please complete and submit this form as soon as possible so I can get the verification process completed.  It is always best to go ahead and complete the form as soon as you realize you do want to meet with me,  so there will not be a hold up because of the verification process.  Usually the  process goes quickly, however, there are times when it takes a little longer.   I CANNOT schedule an appointment with you until I are properly screened.  Last minute, same day appointments seldom can be accommodated until you are an established client.

I am a very low volume, highly selective provider.   

I understand you may feel nervous and uncomfortable providing me the requested information.  You may not understand why I need all of this information.  I take the verification/screening process very seriously.  I am thorough and I do not meet with total strangers.  This process is needed for my safety and security and you should take comfort in the fact I don’t just meet anyone.  It always makes for a better visit when we BOTH feel comfortable and safe.  Please be assured I do NOT contact employers.  Also, I do NOT keep or store any of your personal information.


If you provide me with references, they must have positive feedback regarding their meeting with you - that you were respectful, clean and no negative issues occurred.

If you do not have solid  reference information OR I do not hear back from them in a timely manner, I  will need your personal information to screen you. 

I am very discreet and I do NOT keep any of this information! I am very thorough and I must feel 100% confident with who I agree to meet.  I cannot schedule an appointment until you are properly screened.  If you refuse to get screened then I cannot see you.


When completing this form, please include as much of information as possible including provider references (if you have them), your P411 ID, LinkedIn profile link, link to your website (if you have any of these) and any other Information that could speed up and assist me with the process.

I need one of the following two options:

OPTION 1 - Provide two (2) provider references from ladies you have seen in the past year. They MUST Independent and currently working and advertising on Eros or P411 to be valid references. I need their name and contact information. I will need to hear back from them regarding your visit or you will have to use Option 2. It may be helpful if you contact them right away to kindly ask their permission to use them as a reference and get back to me. This also gives them a heads up that they will be contacted about your visit..

OPTION 2 -  Email me a clear picture of your drivers license and current business card or work badge/ID. If it makes you more comfortable, you can cover all info on your driver license EXCEPT your FULL name and picture which I do need to see.

Thanks for submitting!

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