Phone Sessions

Session Request General Information Preparation Hypnosis Styles

TELEPHONE SESSION REQUEST

Pick Your Poison

Domination and BDSM Hypnodomination

Telephone Hypnodomination

Phone Domination With Hypnosis

Use this form only if you want to be hypnotized. For sessions excluding hypnosis select Domination and BDSM instead.

CONTACT INFORMATION

Name:

*Nicknames are acceptable.

Telephone #:

*Include your country code for numbers outside of the U.S.

E-Mail Address:

*I will contact you initially by email make sure it is correct.

APPOINTMENT TIME

Apointment Time:

*Always use Eastern Standard Time(EST).

*Provide full dates and times including am/pm.

Session Length:

STYLES OF HYPNODOMINATION

*Check all those that apply!

Behavior Modifications Physical Transformations Humiliating or Servile Tasks Live Session Enhancement Fantasy Exploration Total Enslavement & Mind Control

Category Descriptions

SESSSION GOALS

What would you like to experience or accomplish in your telephone session?

PHOBIAS OR FEARS

If you have any fears or phobias list them here. Include traumatic subjects or imagery that would be disruptive to your hypnotic trance.

HYPNOSIS EXPERIENCE

Have you ever been hypnotized?

Yes No

If yes, list here anything significant you remember, especially triggers or suggestions you have been given. List any words or imagery you are highly receptive to and anything that you find particularly potent to a hypnotic induction.

LIMITATIONS

List here any personal or discretionary limitations you need applied to hypnotic suggestions.

*You will be sent an automated confirmation email shortly. If you do not receive this, check your junk mail and if the message is not there alert me.

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