Apply to be considered for a custom BDSM session. Name * First Name Last Name Pronouns * Age * Email * Phone * (###) ### #### Can I text you? Yes No What is your profession? * Past Experience * I have no experience with BDSM. I have been interested in BDSM for a while but have not practiced in real life. I have BDSM experience with intimate partners but not a pro domme. I have some experience with pro dommes. I have a lot of experience with pro dommes. Length of session desired? * BDSM Interests * Can I leave marks on you? (from any desired impact play) Yes No N/A - I am not interested in this type of play. Disclose any medical or psychological conditions for your safety Where did you find me? * You must agree to the following: * I understand a session with Mistress Moda does not involve sex or any unlawful act. I am over the age of 18. Thank you!