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The following form are intended for a FIRST BDSM Session BDSM NEWBIE FORM (Recommended for novices)
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PLEASE COPY & PASTE :
N/A if Not Applicable and " X " a cross your Answer
When COMPLETED SEND TO:
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BDSM NEWBIE FORM :
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1. PEOPLE:
Who will take part?________________________________________________
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Level of Experience ?
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Explanation__________________________________________________________
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2. ROLE :
Who will be submissive?________________________
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Type of scene: Mistress/Slave /Slut /Age Play/ Servant /Butler/Cross Dressing
gender play/ pet play .... other ... see FETISH LIST
Explanation:___________________________________________________________
____________________________________________________________________________
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Will the submissive promptly obey?
Yes_____ No_____
Explanation:___________________________________________________________
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May the dominant "overpower" or "force" the submissive? Yes_____ No____ Explanation:___________________________________________________________
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May the submissive verbally resist? Yes_____ No_____ Explanation:___________________________________________________________
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May the submissive physically resist? Yes_____ No_____ Explanation:___________________________________________________________
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Does the submissive agree to wear a collar? Yes_____ No_____
Explanation:___________________________________________________________
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The submissive agrees to address the dominant by the following title(s)
MARQUISE / MISTRESS : _____________________________________________
Location Required: ___________________________________________________
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4. DATE & TIME:
DATE:__________ TIME :________ LENGTH :________
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More Info ____________________________________________________________
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5. OOPS :
Does everybody involved understand that there is some risk of accident, miscommunication, misconception or unintentional injury?
Yes___ No___
Explanation_______________________________________________________________
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6. HEALTH CHECK :
Submissive's Heath : Any problems with the submissive's...
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heart: yes/no
lungs: yes/no
neck/back/bones/joints: yes/no
kidneys: yes/no
liver: yes/no
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nervous system/mental: yes/no
Explanation:_________________________________________________________
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Is the submissive wearing contact lenses?
Yes_____ No_____
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Does the submissive suffer from Mental Health or any related problems?
Yes_____ No_____
Explanation:_________________________________________________________
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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:_________________________________________________________
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Describe any phobias:__________________________________________________
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Submissive's other medical conditions:_____________________________________
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Any surgical implants (breast, face, etc.)?
Yes_____ No_____
Explanation:_______________________________
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Is the submissive taking , or other non-steroidal, anti-inflammatory drugs? Yes_____No_____
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Other medications the submissive is taking:_________________________________
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Is the submissive allergic to... :
yes/no / Other allergies:_________________________________________________________
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In case of emergency notify:__________________________________
If yes, what will ensure the submissive's safety AT ALL TIMES.
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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:________________________________________________________________
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7. SEX :
which of the following sexual acts are acceptable:
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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: _____________________________________________________________________________________________________________________________
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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
INTOXICANTS: The dominant NEVER uses Drugs or Else during a Session
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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
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Any past bad experiences either with bondage, gags, blindfolds, and/or hoods?
Yes_____ No_____
Explanation:___________________________________________________________
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9. PAIN
Submissive's general attitude toward receiving pain:
_____likes _____accepts _____neutral _____dislikes _____will not accept
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Quantity of pain the submissive wants to receive:
_____none _____small _____average _____large
Explanation:_____________________________________________________
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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:_____________________________________________________
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10. MARKS:
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Is it acceptable to the submissive if the play leaves marks?
Yes___ No___
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Visible while wearing street clothes?
Yes____ No____
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Visible while wearing a bathing suit?
Yes____ No____
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Is it acceptable to the submissive if the play draws small amounts of blood?
Yes____ No____
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Explanation:___________________________________________________________
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11. EROTIC HUMILIATION:
The submissive agrees to accept being referred to by the following terms:
__Slut /___PiG / Sissy ....
Yes _____ No_____
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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:______________________________________________________________
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Any prior really good or really bad experiences in these areas?
Explain :_____________ ___________________________________________________________________
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12. SAFEWORDS :
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SafewordS : "RED" "MONKEY"
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Non-verbal safeword :____________________________________
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Will the "squeezes" technique be used?
Yes____ No____
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Will the "Shake hand" technique be used?
Yes____ No____
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13. OPPORTUNITIES/SPECIAL SKILLS :
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Anything would especially like to try or explore? Yes____ No___
Explanation:___________________________________________________________
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14. FOLLOW-UP :
(Please include a note about who will initiate contact)
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After the session:_______________________________________________________
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The next day:__________________________________________________________
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A week later:_________________________________________________________
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15. ANYTHING ELSE?
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No____ Yes____
Explanation:_______________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________
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