The Awkward Medical Stuff

List all known allergies, including severity and whether or not they require medication (Epi-Pen, etc.):

List any medical conditions you have and any treatments involved (including medications/dosage and side effects):

List any physical issues such as old injuries, joint or muscle problems or conditions that could be aggravated by BDSM activities and any tips to avoid causing flare-ups or further injury:

The More Awkward Sexual Health Stuff

Date and result of last STI/STD test:

Have you ever had sex with someone who has tested positive for HIV/AIDS or any other sexually transmitted infection, even if using protection?

YES

NO

Have you ever had sex with someone in exchange for money or drugs?

YES

NO

Have you ever had sex with someone who has exchanged money or drugs for sex?

YES

NO

Have you ever had sex with someone whose sexual history you didnt know?

YES

NO

The (Potentially) Less Awkward Fetish-Related Stuff

List all known hard and soft limits and any fetish objects or activities that scare you/make you anxious.

If you could rate your level of Dominance and submission using a ratio, what would it be? (ex. 50/50, 70/30 sub/dom)

What qualities do you have that you think help make you a good submissive? Why?

What qualities do you have that you think can sometimes get in the way of your being a good or better submissive? Why?

If you had to pick just ONE fetish to indulge for the rest of your life, what would it be? (And no, submission and BDSM are not acceptable answers!) Why?

What fetishes or kinks have you had the most experience with? How about the least? Keep it general.

How experienced overall do you feel in relation to BDSM and the fetish world?

What would your last serious play partner say about what youre like as a submissive? (If youve never been submissive with a partner before, skip this one.)

What do you need or enjoy as aftercare following a scene?

Fetishes, Checklist Style!

Describe your thoughts on the following fetishes using the following criteria: Tried before Y/N Liked Y/N (if youve tried it)

Interested HY/Y/N/HN (whether youve tried it or not; Hell Yes, Yes, No, Hell No) Intensity preferred: 1-5; 1 being minimal, light, very gentle, short duration; 5 being very heavy, intense, painful/restrictive, very long duration Include other relevant details and exceptions. For example: Impact play: Tried Y, Liked N, Interested Y; only ever experienced riding crops & hated them, willing to try other things Rope bondage: Tried N, Interested HY; intensity 4 but mind my shoulders! Yes, this is all relative, and what one person considers a 3 would be what someone else considers a 5 or a 1. The intention here is just to get a general idea of interest and preferences as a baseline for further discussion.

Bondage
With rope: Tried? Other details: Liked? Interested? Intensity?

With metal restraints: Tried? Other details: Liked? Interested? Intensity?

With leather restraints: Tried? Other details: Liked? Interested? Intensity?

With duct tape: Tried? Other details: Liked? Interested? Intensity?

Mummification (wrapped shoulder to ankle in plastic/pallet wrap or some other medium): Tried? Other details: Liked? Interested? Intensity?

Corporal Punishment
Flogging: Tried? Other details: Liked? Interested? Intensity?

Caning: Tried? Other details: Paddles/Slappers: Tried? Other details: Liked? Interested? Intensity? Liked? Interested? Intensity?

Riding crops: Tried? Other details: Liked? Interested? Intensity?

Spanking, with hands or implements: Tried? Other details: Liked? Interested? Intensity?

Pain and Sensation Play

Sensory deprivation: Tried? Other details: Liked? Interested? Intensity?

Hot waxing: Tried? Other details: Liked? Interested? Intensity?

Ice play: Tried? Other details: Liked? Interested? Intensity?

Bastinado (foot torture): Tried? Other details: Liked? Interested? Intensity?

Tickling: Tried? Other details: Liked? Interested? Intensity?

Scratching: Tried? Other details: Liked? Interested? Intensity?

Biting: Tried? Other details: Liked? Interested? Intensity?

CBT: Tried? Other details: Liked? Interested? Intensity?

Discipline & Control

Having clothing chosen for you: Tried? Other details: Liked? Interested?

Being ordered for in restaurants, cafes, etc.: Tried? Other details: Liked? Interested?

Low protocol: Tried? Other details: Liked? Interested?

High protocol: Tried? Other details: Liked? Interested?

Domestic services & errand running on Dominants behalf: Tried? Other details: Liked? Interested?

Keeping a submissive diary/journal for your Dominant: Tried? Other details: Liked? Interested?

Serving as furniture: Tried? Other details: Liked? Interested? Intensity?

Roleplay & Scenes

Pony play: Tried? Other details: Liked? Interested?

Animal/pet play (other than pony): Tried? Other details: Liked? Interested?

Teacher/student roleplay: Tried? Other details: Liked? Interested?

Interrogation: Tried? Other details: Liked? Interested? Intensity?

Feminisation/sissy play: Tried? Other details: Liked? Interested? Intensity?

Playing with Others

Exhibitionism: Tried? Other details: Liked? Interested?

Given to another for a scene, demo, etc.: Tried? Other details: Liked? Interested?

Watching your Dominant play with others: Tried? Other details: Liked? Interested?

Covert bondage: Tried? Other details: Liked? Interested? Intensity?

Other covert public play (such as symbolic jewelry, nail polish, etc.): Tried? Other details: Liked? Interested? Intensity?

What other fetishes and activities do you really enjoy or would be very interested in trying? List any and all here!