Screen & Book Me

* Required Field

About You

Full Name or Alias: *
Your Age And Year Of Birth: *
City You Are Currently Located In: *
Ethnicity: *
Your Occupation and Job Title: *
Relationship Status: *
How many inches in length is your penis? I like to know prior to make sure you aren't too big for me. *
A CLEAR PHOTO OF YOUR FACE. Preferably a recent selfie. Old pictures, group pictures, blank pictures are NOT accepted: *
A Work Photo Of You On The Job At Your Place Of Employment, Or Your Work ID Card or Bagde Please. You can blur out all of the important information, I just need to see valid proof that you work at that exact job, with a current date. You can blur out your: *
A Photo Of Your Drivers License or Work ID Card or Work Badge. You can blur out everything except your picture. TEXT THIS TO ME, upon confirming appointment after filling this form out. *
If you are visiting, and do not have any work related information with you, I will need to see a photo of your recent flight itinerary OR hotel confirmation email and a picture of your luggage with the bag tags on it, in your hotel room. *

Contact Information

Your Email:
Phone Number To Text You- NO TEXT APP NUMBERS due to creeps, scammers & time wasters. *
Accept SMS/Text: *
Best Times To Text Or Email You: *

Appointment Details

Preferred Date AND Time you want to meet me. Please Be Exact! Keep in mind I am available from 1pm-8pm daily. Put the exact date and time. Ex: March 13, 2022 at 3:42pm. *
Incall or Outcall Request: *
Outcall location if you're requesting an outcall:
What would you like to do from my menu. Please put the name, cost and the length of time: *
Are you a traveler or resident of this area: *
Wardrobe Request(s) or Color Choice:
Special Request(s). Specific things you'd like for me to do to you:
Any Likes or Dislikes. Please keep in mind I do NOT tongue kiss, at all.
Should I wear perfume or no scent: *


Do you have social media? If so, please list your username and the app used? Twitter, Instagram, Snapchat, LinkedIN, Switter. This is just to verify you're real and safe. I will NOT follow or add you, it is just to view and verify you. *
How did you hear about me? Please list ALL of the websites you found me on. If you have a username on any verifiable sites (PD, P411 etc) please list that too. Thank you. *
Do you write reviews on review forums or review boards? *
Are you an active member on the review forum site USASG? *

Health Check

If you're a resident.. Have you traveled out of Hawaii in the past 14 days? *
Have you ever tested positive for COVID-19? *
Do you currently have COVID-19 even with or without symptoms? *
Do you live alone?
Have you been around anyone that could've potentially been exposed to Covid-19?
Can you wear a face mask that covers your nose and mouth upon meeting me? It's required in my building. *
Do you currently have a cold, a fever, coughs, runny nose, sneezing, rashes, pink eye, shortness of breathe, cold sores, etc? *
Do you agree to washing and sanitizing your hands and possibly a fresh shower (If I see fit) when we meet? *
Have you ever tested positive for HIV/AIDS? *
Do you currently have any STD/STI's? Oral or genitals cold sores or warts on your genital areas? If so, I will refuse service. *
Do you agree to a contactless forehead temperature check I will conduct upon your arrival? If your temperature is above 100.4+ I am unable to see you. You have a fever. *

After light screening via text or email, I will send you the link to have access to my screening form and to schedule a meeting with me.


Here you can see my schedule, and see what time works best for us both. Feel free to fill out the screening form, health check and I will get back to you at my earliest convenience with a text or email. If you don't feel comfortable sending in the screening info, text me and we can screen that way. Screening will be required; and mandatory for all new friends! Screening is solely for my safety, freedom, and to gain my trust. All of the information you send in to me, will ONLY be viewed by me, and will be deleted in 24 hours after submission.

If you do not want to screen at all, I AM NOT THE LADY FOR YOU. PLEASE DO NOT BOTHER CONTACTING ME. I only see SAFE and TRUSTWORTHY guys that have nothing to hide and that can follow and respect my simple and brief screening introduction.

Discretion is most importantly key!

Thank you so much for your cooperation and have a beautiful day!


Disclaimer: If you're uncomfortable with filling out the screening form through my website, you're more than welcome to send me all of the photo requirements and information through text 808-436-8665. I need your real number, your work ID card or badge, a picture of you in uniform or on the job, a current selfie, and your drivers license picture with information blurred out. To verfiy it is you who I will be opening my doors to. You can blur out all important traceable information. I don't care about the name of the company and address etc. I just need to see the picture of you with current dates proving that you are currently employed at that exact place of employment, for safety and trust reasons. If you are a student, send me your student ID card with current dates. If you are unemployed, please let me know and you will need to do a different screening. :) My safety and freedom comes first!