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The Danny Gold Experience

Please fill out the following form prior to your first appointment or consultation so that I may have a complete picture of your needs and desires. Then, you may book a phone consultation with me for $44 (this will credit toward your deposit should you choose to book.

This form is secure and 100% confidential, only seen by my assistant and myself.

Still don't like it? Click HERE.

New Client Discovery Form

Please provide complete, accurate information for the quickest screening and best experience!

Full Legal Name

Phone

City of residence

Birthday

Gender

Man

Woman

Non-binary

Trans

Other

Sexual Orientation

Straight

Bisexual

Gay/Lesbian

Pansexual

Discovering

Your Power Identity

Top

Bottom

Dominant

Submissive

Switch

Date & Time requested

Session Location

Incall

Outcall to home

Outcall to hotel/bnb

Services Requested:

DGE

Shadow Work

Retreat

Medicine Journey

Special Date Package

Virtual Services

City of Appointment

If outcall to home:

pets

indoor smoking

live with someone else

nosy neighbors

What is your prior experience?

Length of Appointment

If "yes" please explain

What are your goals?

Turn ons? Special requests?

Any health concerns? Turn offs?

Personal Message

Provider References

Other screening info

I understand that in-depth screening and government issued ID will be required for in-person sessions.

Thanks for submitting! My assistant will contact you within a few hours Monday-Saturday!

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