Interview

By Norische

This is a questionnaire that is specifically designed to assist in communication between two consenting adults. This is by no means a complete list of questions but it will guide both parties as to what should indeed be discussed prior to BDSM focused play. This list is focused on general information and safety issues. This interview is designed for first time meeting or scening; this interview is not meant for 24/7 or long term relationships… remember everyone must start somewhere. Be as honest and as thorough as possible.

Name: ______________________________________________________________

Age ____________ Gender___________ Sexual Orientation ____________________

How Top wishes to be addressed.______________________________________

I am mainly into: (D/s, Sadism, Masochism, Bondage, Fetish, Power Exchange)

Safety Codes
Red: Stop______________________________________
Yellow: I'm ok but slower/less/careful______________________________________
Green: I'm fine, go on, more______________________________________

Safeword:______________________________________

Visible bruises/cuts/marks must be avoided (Y/N)

Pictures or Video (Y/N)

Public (anyone is welcome to watch, I am an exhibitionist)
Semi-Public (I don't mind small crowds)
Semi-Private (ask for approval before letting someone watch)
Private (I do not like anyone to watch)

Heath Issues: (Hemophilia, Allergies, Asthma, Breathing Problems, Blood Sugar Issues, Circulation)

Allergies and how they affect you.___________________________________________
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Medications: Have you taken any medications, including Aspirin within the last 4 - 6 hours? Please include any Prescription medication you are on. Current Medications, dose, and what the medication is prescribed for.

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Medical Conditions (give as much detail as possible)
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Surgeries (give as much detail as possible)
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Eye Glasses (Y/N)

Contacts (Y/N)

Any current medical injuries or problems...(sinuses, pulled muscle. Etc…)
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No hit zone if any:

Phobias or Fears:
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Other Remarks: (safety issues, triggers, etc)
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I want aftercare (Y/N)

I like to talk after a scene (Y/N)

I want extensive verbal communication during a scene (Y/N)

I want music during the scene (Y/N)
Sexual Contact (Y/N)
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Clothing
Fully Clothed
Shirt Off
Underwear Only
Fetish Clothing
Nude

Limits:
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As with everything this is my opinion, take what you will and leave the rest. If you wish to contact me, my email address is Norisch1@mchsi.com . If you wish to see more of my work you may find a complete listing of all my writings at... http://groups.yahoo.com/group/Norisches_Quill/?yguid=99788111 in the files section.