PART ONE: GENERAL QUESTIONS & INFORMATION
=========================================
A. What is your level of experience?
1. Very experienced
2. Experienced
3. Limited experience
4. Beginner
B. How long have you known of your interests?
1. As long as I can remember
2. 5 years or more
3. 1 to 4 years
4. Less than 1 year
C. What is your sexual orientation?
1. Heterosexual exclusively
2. Bisexual
3. Homosexual
4. BiCurious
D. What kind of relationship do you prefer?
1. Long term, live in
2. Offline, meeting often
3. Offline, meeting occasionally
4. Online only
5. Not sure yet
E. Main interest
1. Sensual and physical
2. Psychosexual and mental
3. Both equally
F. Are you... (rate each from 1 to 10)
______ Sadistic
______ Masochistic
______ Dominant
______ Submissive
G. Your level of interest in bondage:
1. Total helplessness
2. Light bondage
3. Not my favorite thing
4. Outside my limits
5. Never tried it
H. Pain (what you are, or what you're looking for)
1. Pain slut
2. Whipping, caning, paddling
3. Light paddling, sensual whipping, no marks
4. Punishment only when necessary
5. Interested, but never tried it
6. WAY beyond limits
I. What do you believe the purpose of pain in a session is?
1. Pain is a reward
2. Pain is a punishment
3. For training or correction only
4. Whatever pleases my partner
5. Not sure
J. Sex in a scene, for me is...
1. An absolute must
2. Expected, unless punishment is taking place
3. An enhancement
4. Not necessary or expected
5. Out of the question
K. Which settings are you comfortable playing in?
1. Public play
2. Scene parties
3. Intimate groups of 1 to 3 other couples
4. Three way play
5. One on one
L. Who can know of your activities?
1. No one
2. A very few trusted friends
3. Other scene people
4. Doesn't matter who knows
PART TWO: INTERESTS, PREFERENCES, LIMITS
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M. Role Playing: Below are listed several examples of roles to be
played by either Dom/Domme or sub. Please list those which you are
interested in, and those you'd like to see your partner play.
Amazon Baby Barbarian Bitch-Goddess
Boss Burglar Child Clergy
Cowboy Cowgirl Daddy Doctor
Evil Priest Evil Priestess Femme Fatale French Maid
God Goddess Hooker Indian
Inquisitor Interrogator Hero Kidnap Victim
Knight LeatherMan Master Mentor
Mistress Mommy Nun Nurse
Rapist Role Reversal Pet Pimp
Pirate Policeman Ponyboy Ponygirl
POW Prince Princess Principal
Puppy Savage Secretary Sex Object
Sissy Slave Slave Owner Slut
Student Suspect Teacher Teen
Torturer Victim Warrior Wild Beast
Roles I would like to play:
__________________________________________________________
__________________________________________________________
Roles I would like my partner to play:
__________________________________________________________
__________________________________________________________
N. List any specific fetishes you have (such as foot worship,
body types):
__________________________________________________________
__________________________________________________________
O. List any medical, physical or emotional concerns (past breaks,
sprains, chronic conditions or phobias):
__________________________________________________________
__________________________________________________________
P. List your limits here:
__________________________________________________________
__________________________________________________________
Q. List your concerns about the depth and exclusivity of a relationship:
__________________________________________________________
__________________________________________________________
R. List your preferred method of birth control and avoidance of STD's:
__________________________________________________________
__________________________________________________________
S. Below are listed several D/s activities. Please rate each of
these from 1 to 6 using the following scale:
1 = YES!!!
2 = Mmmm, I like this
3 = Doesn't excite me, but I'll do it for you
4 = Intriguing, but scary
5 = Embarrassed to admit I want this
6 = Absolutely not!!
1 _____ Spanking, by Hand
2 _____ Leather Paddle
3 _____ Wooden Paddle
4 _____ Belt or Strap
5 _____ Switch
6 _____ Deerskin Cat o' Nine
7 _____ Leather Cat o' Nine
8 _____ Braided Cat o' Nine
9 _____ Knotted Whip
10 _____ Rubber Whip
11 _____ Single Lash
12 _____ Cane
13 _____ Fiberglass/Plastic Rod
14 _____ Riding Crop
15 _____ Furlined Paddle
16 _____ Mental Bondage
17 _____ Silk Scarves
18 _____ Nylon Rope
19 _____ Cotton Rope
20 _____ Chains
21 _____ Leather Bonds
22 _____ Spandex Bonds
23 _____ Plastic Wrap
24 _____ Body Bags
25 _____ Steel Shackles
26 _____ Arm Sleeves
27 _____ Straight Jackets
28 _____ Breast Bondage
29 _____ Genital Bondage
30 _____ Gags
31 _____ Leather Cuffs
32 _____ Infibulation
33 _____ Spreader Bars
34 _____ Ceiling/Wall Hooks
35 _____ Cages
36 _____ Slings/Swings
37 _____ Stocks
38 _____ Crosses
39 _____ Pillory
40 _____ Suspension, on Toes
41 _____ Suspension, Full
42 _____ Outdoor Setting
43 _____ Indoor Setting
44 _____ Public Setting
45 _____ Semi-public Setting
46 _____ Private Setting
47 _____ 1 to 3 Hours
48 _____ 3 to 6 Hours
49 _____ Overnight Duration
50 _____ Blindfolds
51 _____ Hoods
52 _____ Headphones/Earplugs
53 _____ Tickling
54 _____ Feathers/Fur
55 _____ Sexual Teasing
56 _____ Sexual Denial
57 _____ Chastity Belt
58 _____ Pinching
59 _____ Hair Pulling
60 _____ Nipple Clamps/Clips
61 _____ Clothespins
62 _____ Genital Torture
63 _____ Weights
64 _____ Cock Rings
65 _____ Ball Stretchers
66 _____ Water Torture
67 _____ Ice
68 _____ Oils, Lotions, Spices
69 _____ Hot Wax
70 _____ Fire and Ice
71 _____ Needles
72 _____ Cutting
73 _____ Abrasions
74 _____ Electric Torture
75 _____ Digital Sex
76 _____ Directed Masturbation
77 _____ Vaginal Sex
78 _____ Oral Sex
79 _____ Vibrators/Dildoes
80 _____ Strap-ons
81 _____ Anal Sex
82 _____ Anal Plugs
83 _____ Multiple Penetrations
84 _____ Anilingus
85 _____ Vaginal fisting
86 _____ Anal Fisting
87 _____ Fantasy Rape
88 _____ Directed Bisexuality
89 _____ Threesomes
90 _____ Groups
91 _____ Foot Kissing
92 _____ Kneeling
93 _____ Crawling
94 _____ Lead on Leash
95 _____ Dirty Words
96 _____ Verbal Abuse
97 _____ Public Embarrassment
98 _____ Face Slapping
99 _____ Cross Dressing
100 _____ Secret Sex in Public
101 _____ Public Display
102 _____ Public Sex
103 _____ Public Whipping
104 _____ Infantilism
105 _____ Golden Showers
106 _____ Enemas
107 _____ Innocent Dress
108 _____ Slutty Dress
109 _____ Prim and Proper
110 _____ Ultra-Feminine
111 _____ French Maid
112 _____ Child/Baby Roles
113 _____ Slave
114 _____ Macho
115 _____ Biker
116 _____ Leathers
117 _____ Spandex
118 _____ Rubber/Latex
119 _____ Masks/Hoods
120 _____ Costumes
121 _____ Lingerie
122 _____ Garters/Stockings
123 _____ Corsets/Cinches
124 _____ Boots
125 _____ High Heels
126 _____ Tattooing
127 _____ Body Piercing
128 _____ Branding
129 _____ Maid Service
130 _____ Shaving
131 _____ Humiliation
132 _____ Foot Worship
133 _____ Exhibitionism
134 _____ Voyeurism
135 _____ Hand/Ankle Cuffs
T. Listed below are 6 parts of the body and 3 categories. Using the
following letter codes, rate each as what is acceptable to you:
N = Never L = Light ? = Unsure
T = Thuddy M = Medium
S = Stingy H = Heavy
Part of Body Bondage Corporal Torture
Back/Shoulders _____ _____ _____
Bottom/Thighs _____ _____ _____
Breasts/Chest _____ _____ _____
Genitals _____ _____ _____
Feet/Ankles _____ _____ _____
Wrists _____ _____ _____
Fri Jan 09, 2015 2:58 am