Book a date with me!

Please complete all fields below. Screening is required, and can include a Government ID, LinkedIn profile, reference from an active provider you’ve seen in the last three months (provide name and contact information) or deposit by Bitcoin/credit card. If you wish to provide a deposit or a copy of your ID, please indicate so in the “Screening” field below. Please note that incomplete forms without adequate screening information will be ignored.

If you’d like to pay a deposit via credit card, please use this link instead of the form below.

 
Phone *
Phone
Include a brief introduction and information about the day, time, and length of booking you request.
If you have screening information to provide, please include it here. Booking requests without screening information will be ignored.
How did you hear about me? *