Thank you for your interest in booking an engagement with me. Please fill out the following screening information about yourself. If you don't receive a response back from me within 24hrs it's because I'm not interested in seeing you for the following reasons:
I won't see any new clients without two verified provider references listed and she must be a reputable provider in your community.
I won't see clients under the age of 35yrs.
Occupation and phone info are optional to fill on form.