Reservations – Addicted to Bliss

If we have never met, I will need to screen you for safety purposes. You will find a contact form at the end of this page. Please fill it out completely.

Please submit a clear picture of your full Driver’s License card *WITH ONLY YOUR ADDRESS BLURRED OUT*
Booking form will be rejected if any other info is marked out on your DL.

Please submit a link to your LinkedIn profile and provide your real phone number *NO APP/GOOGLE NUMBER*

There are no other options. Please respect my verification process and send necessary information upon initial contact. After the screening process is complete, I will contact you to confirm our appointment.

In order for this form to reach me, you must fully complete each box. Write N/A if not applicable. If you’d like to include references, you may do so. However, references alone will not be sufficient for the verification process.

Name*
First Last
Email*
Age*
Phone*
Online Screening Service
If you are a member of one of the following screening services, please provide the necessary details I need to verify you.
Preferred 411*
ECCIE Handle*
References
Remember to include your references with their contact information.
If you do not have references, please send me a copy of your driver's license (you can blur out address) a screenshot of your LinkedIn profile & your real #"
Companion #1*
Please include website and contact information
Companion #2*
Please include website and contact information
Driver's Licence*
Max. file size: 512 MB.
Please ensure that your address is blurred out
Screenshot of LinkedIn Profile*
Max. file size: 512 MB.
Preferred Date*
MM slash DD slash YYYY
Preferred Time*

: Hours

Minutes

AM/PM
Duration*
Preferred date with new clients is 1 1/2 hours.
How did you find me?*
A little bit about you...*