Appointments

To request an appointment, fill out the form below.
If no response within 48 hours, feel free to follow-up at LillianWarren@protonmail.ch.
Incomplete or explicit submissions will be ignored.

Basic Information:
End-to-end encrypted communication preferred (ProtonMail, iMessage, Signal or WhatsApp)

Full Name

Confirm Email

Resident City & State

Age

Contact Number

What is your preferred method of contact?

Email iMessage Signal WhatsApp

Appointment Details:

Preferred Date

Preferred Time

Duration

Appointment Type

Appointment Location

Alternate date & time if unavailable?

Interested in a friend joining?

Companion References:
Provide the name, email and website for at least two reputable companions you have spent time with in the past 12 months.
References will only be communicated via email.

Reference #1

Reference #2

Reference #3

Employment Information:
If no references, provide employment details for verification purposes.

Company Name

Your position or title

Company Website

Main company phone number

Your direct line and/or extension

Phone etiquette or cover story to use when calling?

Miscellaneous:

How did you find me?

Is there anything else you would like to tell me? Special requests?

Optional

By checking this box, you indicate that you have read my etiquette section and agree to my cancellation policy.

Appointments

Appointments:

Email:

Newsletter:

Questions: