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The following form are intended for a FIRST BDSM Session  BDSM NEWBIE  FORM (Recommended for novices) 

PLEASE  COPY &  PASTE  : 

N/A  if  Not Applicable  and   " X "  a cross  your Answer

When  COMPLETED SEND TO:

MQ123CONSULT@GMAIL.COM

BDSM  NEWBIE  FORM :

1. PEOPLE:

  

Who will take part?________________________________________________

Level of Experience ? 

Explanation__________________________________________________________

2. ROLE :

Who will be submissive?________________________

Type of scene: Mistress/Slave  /Slut /Age Play/ Servant /Butler/Cross Dressing

gender play/  pet play .... other ... see  FETISH LIST

Explanation:___________________________________________________________

____________________________________________________________________________

Will the submissive promptly obey?

Yes_____ No_____

Explanation:___________________________________________________________

May the dominant "overpower" or "force" the submissive? Yes_____ No____ Explanation:___________________________________________________________

May the submissive verbally resist? Yes_____ No_____ Explanation:___________________________________________________________

May the submissive physically resist? Yes_____ No_____ Explanation:___________________________________________________________

Does the submissive agree to wear a collar? Yes_____ No_____

Explanation:___________________________________________________________

The submissive agrees to address the dominant by the following title(s) 

MARQUISE / MISTRESS : _____________________________________________

Location Required: ___________________________________________________

4. DATE & TIME:

DATE:__________ TIME :________  LENGTH :________

More Info ____________________________________________________________

5. OOPS :

Does everybody involved understand that there is some risk of accident, miscommunication, misconception or unintentional injury?

Yes___ No___

Explanation_______________________________________________________________

6. HEALTH   CHECK :

Submissive's Heath : Any problems with the submissive's...

heart: yes/no

lungs: yes/no

neck/back/bones/joints: yes/no

kidneys: yes/no

liver: yes/no

nervous system/mental: yes/no

Explanation:_________________________________________________________

Is the submissive wearing contact lenses?

Yes_____ No_____

Does the submissive suffer from Mental Health or any related problems?

Yes_____ No_____

Explanation:_________________________________________________________

Does the submissive have a history of...

seizures: yes/no

dizzy spells: yes/no

diabetes: yes/no

high or low blood pressure: yes/no

fainting: yes/no

asthma: yes/no

hyperventilation attacks: yes/no

Explanation:_________________________________________________________

Describe any phobias:__________________________________________________

Submissive's other medical conditions:_____________________________________

Any surgical implants (breast, face, etc.)?

Yes_____ No_____

Explanation:_______________________________

Is the submissive taking  , or other non-steroidal, anti-inflammatory drugs? Yes_____No_____

Other medications the submissive is taking:_________________________________

Is the submissive allergic to... :

yes/no / Other allergies:_________________________________________________________

In case of emergency notify:__________________________________

 

If yes, what will ensure the submissive's safety AT ALL TIMES.

no bondage to chair/bed/etc.: yes/no

no gag: yes/no

silent alarm: yes/no

third person present: yes/no

telephone/radio/panic button within submissive's reach: yes/no

Other:________________________________________________________________

7. SEX :

which of the following sexual acts are acceptable:

Self-Masturbation/submissive to dominant :Yes_____ No_____

Fellatio to StrapOn Dildo/Male Subject/submissive to Dominant:Yes_____ No_____

Anal fisting/dominant to submissive:Yes_____ No_____

Anal intercourse? dominant to submissive 

Is swallowing semen acceptable? Yes_____ No_____

Is any participant menstruating? Yes_____ No_____

Force BiSexuality? Yes_____ No_____

Force Feminisation? Yes_____ No_____

SissiFication? Yes_____ No_____

Any Hard Limits ? Things you Wouldnt do at All*: Yes_____ No_____

If YES * Please Explain: _____________________________________________________________________________________________________________________________

Will sex toys such as vibrators, dildos, butt plugs, etc. be used? Yes/No

If yes, describe:_____________________________________________________

ALL the above activities will involve condoms, gloves, and/or other barriers

INTOXICANTSThe dominant NEVER uses Drugs or Else during a Session 

8. BONDAGE :

The submissive agrees to allow (only) the following types of bondage... 
hands in front: yes/no 
hands behind back: yes/no 
ankles: yes/no 
knees: yes/no 
elbows: yes/no 
wrists to ankles (hog-tie): yes/no 
spreader bars: yes/no 
tied to chair: yes/no 
tied to bed: yes/no 
use of blindfold: yes/no 
use of gag: yes/no 
use of hood: yes/no 
use of rope: yes/no 
use of tape: yes/no 
use of leather cuffs: yes/no 
use of handcuffs/metal restraints: yes/no 
suspension: yes/no 
mummification with plastic wrap, body bag, or similar technique: yes/no

Any past bad experiences either with bondage, gags, blindfolds, and/or hoods?

Yes_____ No_____

Explanation:___________________________________________________________

9. PAIN

Submissive's general attitude toward receiving pain:

_____likes _____accepts _____neutral _____dislikes _____will not accept

Quantity of pain the submissive wants to receive:

_____none _____small _____average _____large

Explanation:_____________________________________________________

The following types of pain are acceptable...

spanking: yes/no

paddling: yes/no

flogging: yes/no

caning: yes/no

face slaps: yes/no

biting: yes/no

nipple clamps: yes/no

genital clamps: yes/no

clamps elsewhere: yes/no

locations:_________________

hot creams: yes/no

ice: yes/no

hot wax: yes/no

tickling: yes/no

Other types/methods of pain:_____________________________________________

Additional remarks:_____________________________________________________

10. MARKS:

Is it acceptable to the submissive if the play leaves marks?

Yes___ No___

Visible while wearing street clothes?

Yes____ No____

Visible while wearing a bathing suit?

Yes____ No____

Is it acceptable to the submissive if the play draws small amounts of blood?

Yes____ No____

Explanation:___________________________________________________________

 

11. EROTIC HUMILIATION:

The submissive agrees to accept being referred to by the following terms:

__Slut /___PiG / Sissy ....

Yes  _____  No_____

The submissive agrees to the following forms of erotic humiliation...

 
"verbal abuse": yes/no 
enemas: yes/no 
forced exhibitionism: yes/no 
spitting: yes/no 
water sports: yes/no 
scat games: yes/no 
face slapping: yes/no

Other:______________________________________________________________

Any prior really good or really bad experiences in these areas?

Explain :_____________ ___________________________________________________________________

12. SAFEWORDS :

SafewordS :     "RED"    "MONKEY"  

Non-verbal safeword :____________________________________

Will the "squeezes" technique be used?

Yes____ No____

Will the "Shake hand" technique be used?

Yes____ No____

13. OPPORTUNITIES/SPECIAL SKILLS :

Anything would especially like to try or explore? Yes____ No___

Explanation:___________________________________________________________

14. FOLLOW-UP :

(Please include a note about who will initiate contact)

After the session:_______________________________________________________

The next day:__________________________________________________________

A week later:_________________________________________________________

15. ANYTHING ELSE?

No____ Yes____

Explanation:_______________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________

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