This may be the most detailed questionnaire you have ever completed about yourself. However, in a Master/slave relationship, complete openness is required for it to be successful.
The potential slave agrees to answer all questions with total honesty and as much soul searching as he/she is able. This is required regarding each and every question.
The basis of the relationship with your potential Master and your growth as His slave demands total honesty and relaxed, focused attention to all details requested. Copy and past this form, answer the questions and then send to me via e-mail in within Seven (7) days. The spacing of this questionnaire does not determine the length of your answers. If you are unable to wholeheartedly give this your focused attention, DO NOT ANSWER THE QUESTIONNAIRE, however please notify me through email when would be a better time for you to sit down and complete the Questionnaire.
Date Received:
Date Complete:
Name:
Contact telephone number and times best to reach you:
Email addresses:
Instant Messenger IDs (Ex: Yahoo, Gmail, Skype, etc):
Other means of contact:
Age:
Gender:
Current city and state which you reside:
Part one: General Information
How many years of experience do you have?
How long have known of your interest in bdsm?
What is your sexual orientation?
Heterosexual
Bisexual
Homosexual
Bi-curious
Are you open to all training being controlled by the Master in question?
What kind of relationship are you presently able to provide to a Master?
Offline, live in
Offline, meeting often
Offline, meeting occasionally
Online and offline, meeting occasionally
Online only
Not sure yet
What is your main interest?
Sensual and physical
Psychosexual and mental
Both equally
Serving your Master in all regards
Are you…
(1=lowest, 10=highest. If you wish to explain feel free to do so.)
Sadistic ____
Masochistic ____
Dominant/Master____
submissive/slave____
Switch____
Your level of interest in bondage:
Total helplessness
Light bondage
Not my favorite thing
Outside my limits
Never tried it
What is your pain level/experience?
Pain Slut
Whipping, Caning, Paddling
Light paddling, sensual whipping, no marks
Not interested.
Part Two: Detailed Questions
This are short essay questions. All questions should be answered in full with a minimum of two sentences.
I seek and require the guidance of a Master to…?
(What are you seeking out of the relationship as the slave?)
I seek and require the guidance of a Master because…?
(Why do you have the need for a Master?)
How important is the fulfillment of these needs to you?
I seek to provide my Master with…?
(Psychologically, emotionally, and sexually)
My concept/definition of ‘submission’ is …?
My concept/definition of ‘servitude’ is …?
My concept/definition of ‘commitment’ …?
My favorite sexual fantasy is…?
In what areas do you believe you need concentrated training?
Are you willing to accept the idea of being trained as if you are the property of your Master?

Describe how you will serve your Master in his absence.

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The following questions deal with your current and initial preferences.

Do you prefer your master to be… (Select all that apply)Rough, tough, and stubborn
Firm, stern, yet considerate
Something else? What?
Do you prefer to: (Select all that apply)Be commanded and ordered about
Be given a set of rules to obey
Know the reason for some commands/orders
Have no say in your training and use
Have input in your training and use
Where would you place your sexual level/preference?
I like sex anytime.
I like sex, but there are other things that are just as important to me.
I like it about three times a week
Once a week
I can live without sex
I like sex; however, I like it in my relationship, outside of a relationship I can live without it.
Limits
Please list all known hard limits that you know of and would like to be maintained.
Please list all known soft limits that you know of and would like to be known.
This next part please prepare in a resume style format the following is a checklist for said format.

Prepare a detailed description of your former training. Start at the beginning and take it Master by Master.

Describe the type of training you received and the scenes you have had.
Explain any problems with the relationships.
How long were you trained and what major thing you learned from each?
What you liked and did not like about previous training experiences.
Describe how you were rewarded and punished.
Describe any experience you have had as a switch.
Part three: Experience level and Interests
Your potential Master does not necessarily engage in any of the following-described conduct. However, it is essential that you provide scrupulously accurate answers so They can realistically assess your qualifications as well as whether I need to address they need to address other issues in your personality besides your desire to serve.
For each item, you need to provide two answers:
For experience, write Yes or No next to each item to indicate if you have ever DONE at that activity. For willingness, indicate for each item how you feel about DOING that activity by rating it on a scale of NO or 0 to 5. ( “?” means you don’t understand what the item is attempting to describe. NO MEANS YOU WILL NOT DO THAT ITEM UNDER ANY CIRCUMSTANCE.)
NO – Means basically a hard limit and that you have absolutely no desire to do this.

0 – (zero) indicaties you have utterly no desire to do that activity, but you would permit the Master to it if they really wanted it.
1 – Means you don’t want to do or like this activity, but wouldn’t object to it if asked of you.
2 – Means you are willing to do this activity, but it has no special appeal for you.

3 – Means you usually like doing this activity, at least on an irregular/occasional basis.

4 – Means you like doing this activity, and would like to experience it on a regular basis.
5 – Means the activity is a wild turn-on for you, and you like it as often as possible.
Note* Please note any additional information or nuances which might be important for your Master along with your answers.
BDSM Check List:
Anal Sex (Top):
Anal Sex (Bottom):
Anal Plugs (Small):
Anal Plugs (Large):
Anal Plugs (Public, under clothes):
Animal roles:
Arm ; Leg Sleeves (Binding):
Asphyxiation:
Ass Licking (Giving):
Ass Licking (Receiving):
Bathroom use control:
Beating (Soft):
Beating (Hard):
Bestiality (K-9):
Bestiality – Other:
Blindfolds:
Being Bitten:
Ben Wa balls or Kegel balls:
Breath Control:
Branding:
Boot black:
Boot worship:
Bondage (Light):
Bondage (Heavy):
Brown showers (Scat):
Cages:
Caning:
Catheterization:
Cattle Prod/Stun Gun:
Cells/Closets:
Chains:
Chasity belts:
Cigar Service:
Clothespins:
Cock Sucking (Spitting/Swallowing):
Collars (Public/Private):
Cuffs (Leather):
Cuffs (Metal):
Diapers (Wearing):
Denied Privacy:
Describe the denial:
Douches as part of play:
Double penetration (anal, oral, or vaginal):
Dildos:
Eating Pussy:
Electricity:
Enemas (Cleansing):
Enemas (Retention/Punishment):
Enforced chastity:
Erotic dance (Private):
Erotic dance (Public):
Examinations (Physical):
Exercise (Forced/required):
Exhibitionism:
Eye contact restrictions:
Face slapping:
Fantasy rape:
Fear (Being scared):
Fisting (Anal):
Fisting (Vaginal):
Flame Play (Fire play):
Foot Worship:
Forced Masturbation:
Forced Nudity (Private):
Forced Nudity (Public):
Forced Servitude:
Full Head Hoods:
Gags (Cloth):
Gags (Inflatable):
Gags (Phallic):
Gags (Rubber):
Gags (Tape):
Gas Masks:
Given away to other Masters (Temporary):
Servicing another Master upon command:
Golden Showers:
Hairbrush Spanking:
Hair Pulling:
Hand Jobs (Giving):
Hand Jobs (Receiving):
Harnessing (Leather/Rope):
Homage with tongue (Non-sexual):
Hoods:
Hot Creams on genitals (Ex: Ben-gay/Icy Hot):
Hot oils:
Hot waxing:
House Work (Doing):
Human Puppies/Kittens:
Humiliation:
Ice Cubes:
Immobilization:
Interrogation:
Lactation Training:
Lactation (Milking tits):
Leather Clothing:
Leather Restraints:
Licking (Non-Sexual):
Lingerie (Wearing):
Manacles ;Iron:
Massage (Giving):
Massage (Receiving):
Medical Scenes:
Modeling for Erotic Photos:
Photographing Training Sessions with your Master:
Mouth bits:
Multi-Partners:
Mummification:
Needle Play:
Nipple Clamps:
Nipple Rings (Piercing):
Nipple Play/Torture:
Nipple Weights:
Obeying verbal commands:
Oral/anal play (Rimming):
Over-The-Knee Spanking:
Orgasm Denial:
Orgasm Control:
Outdoor Scenes:
Outdoor Sex:
Pain (Mild):
Pain (Severe):
Piercing (Temporary, Play-piercing):
Piercing (Permanent):
Primal Play:
Prison Scenes:
Protocols (Low/Med/High):
Punching:
Punishment Scene:
Pussy Torture:
Restrictive Rules:
Rubber/latex Clothing:
Rope Body Harness:
Role Playing:
Saran Wrapping:
Sensory Deprivation:
Serving as Ashtray:
Serving as Furniture:
Serving as a Maid:
Serving as Toilet (Urine):
Serving Orally (Sexually):
Serving other Masters (Supervised):
Serving other Masters (Unsupervised):
Serving others as a Sex slave:
Shaving (Body hair):
Shaving (Head Hair):
Slave Positions Training:
Sleep Deprivation:
Spandex Clothing:
Spanking:
Speech Restrictions:
Spitting:
Spreader Bars:
Stocks:
Straight Jackets:
Strapping (Full body beating):
Strap-on (Giving):
Strap-on (Receiving):
Suspension:
Supplying New Partners for Master:
Swallowing Semen:
Swallowing Urine:
Swapping (Swinging):
Tattoos:
Tens Unit (Electrical Toy):
Tickling:
Uniforms:
Verbal Humiliation:
Vibrator on Genitals:
Violet Wand (Electrical Toy):
Video (Watching others):
Video (Watching yourself):
Waxing (Hair Removal):Whipping:
Wooden Paddles:
Wrestling:
NO – Means basically a hard limit and that you have absolutely no desire to do this.

0 – (zero) indicaties you have utterly no desire to do that activity, but you would permit the Master to it if they really wanted it.
1 – Means you don’t want to do or like this activity, but wouldn’t object to it if asked of you.
2 – Means you are willing to do this activity, but it has no special appeal for you.

3 – Means you usually like doing this activity, at least on an irregular/occasional basis.

4 – Means you like doing this activity, and would like to experience it on a regular basis.
5 – Means the activity is a wild turn-on for you, and you like it as often as possible.
Note* Please note any additional information or nuances which might be important for your Master along with your answers.
What do you believe is your best physical feature?
What do you believe is your worst physical feature?
Do you have problems controlling you temper?
Do you have any tattoos or piercing?
What has been your most intense scene involving the lifestyle?
Part Four: Background
Health Issues
Do you smoke?
How often?
Do you drink?How often? How much?
Have you ever been in an Alcohol abuse program?
Do you use drugs?
Prescription?Other drugs?
Have you ever been enrolled in a drug abuse program?
Do you have any Mental problems?
Describe if yes:
Do you have any disabilities (Visible/invisible)?
Describe if yes:
Do you wear glasses?
Do you wear contacts?
Do you have any special Dietary needs or restrictions?
Are you allergic to Dogs, Cats, or Other?Describe if other:
Do you have any sexually transmitted diseases or infections?
When was your last test?
Describe if yes:
Are you subject to any form of loss of consciences or seizures?
Do you have panic attacks or extreme phobias?
Describe if yes:
Do you now or have you suffered from depression?
What was your last illness that resulted in hospitalization and when?
Domestic Skills
Please describe your abilities in domestic service such as cooking, cleaning,
and general house work.
Cooking:
Cleaning:
Laundry:
Childcare:
Scheduling:
Other Skills
Describe your abilities at:
Massage:
Dancing:
Computer skills:
Book Keeping:
Financial Record Keeping:
List any other skills you may have here:
Sex/BDSM Toys and Equipment
List any Sex/BDSM toys you may own:
List any Sex/BDSM equipment or furniture you may own:
Relationships
Current Marital status:
Have you been married before?
If yes, please give a short summary of details:
Have you ever been unfaithful to a Lover or Master?
If yes, please give a short summary of details:
When other people met you, what do you this is the MOST important thing about you that they like?
Overall, what do you think makes you the sort of person other people want to be around?
What personality trait of yours do you think your friends like the least?
Criminal Background
Have you violated any law in the past two years?
If yes, describe:
Have you ever been arrested?
If yes, describe:

Military Background
Have you ever in the military?
If yes: Rank: MOS:
Duty Stations: Current Unit:
Slave Training Questions
Do you feel that any current or prior religious beliefs will cause you personal conflict in slave training and obedience?
What is your biggest fears about undergoing slave training?
What do you look forward to most about slave training?
Are you willing to sign a pre-contract or training agreement that details the direction of your training?
Are you able to relocate to the Master if needed?
Are there any circumstances in which you think you would hesitate to follow your Master’s orders?
In what areas would you not be willing to defer to your Master’s orders?
Misc. Questions
Do you have problems reaching orgasm?
What is the most you have ever orgasmed in a 24-hour period?
How often do you masturbate?
What methods do you use?
Do you freely admit when you have done something wrong?
Are you prepared for the punishment that may follow?
Do you have any strongly felt political beliefs?
If yes, describe:
What is your worst habit?
Do you wish for help stopping?
Please stop here. Thank you for completeing the Questionnaire. If there was anything you feel was not covered in here please feel free to use the following lines to cover it. If you have any questions, comments, or concerns then please place them here as well.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please sign and date upon completion
Signature: _____________________________Date: __________

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