Session Request Form

I’m pleased to see you’re ready to take the first step toward booking a session. Whether you’re new to BDSM or an experienced participant, I welcome submissives, masochists, and fetishists seeking a genuine and authentic experience.

Before submitting your session request, review Tribute & Offerings and Expectations & Protocol to ensure we are a good match. Screening is a vital part of the process, ensuring safety, compatibility, and mutual respect for both our time.

Once your inquiry form is successfully submitted, you will receive a confirmation message. If no confirmation is received, your request was not submitted properly, and I did not receive it. If you have not heard back from me, check your spam folder to ensure my response has not been overlooked. Be advised that those who fail to follow my directions will be ignored.

Summer/Fall 2025 I will be guest-spotting at The Wormhole in Tempe, AZ.

All of the specialty equipment listed on my website, except for the furniture, is still available for use. In addition to my extensive collection of gear, the Wormhole features an elaborate medical room to live out your most twisted MedFet fantasies…and perhaps even develop a few new ones.

My personal dungeon, The Church of Satanatrix, will reopen in it’s current downtown Phoenix location later this year.

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I understand a deposit is required to book a session with Lady Vi: *

• YES
• NO (If you are not prepared to place a deposit you may discontinue filling out the rest of this form)

Email *

Phone Number *

Your Message (Include booking details such as your available dates/time to expedite the booking process): *

Select an offering from the dropdown menu: *Dungeon SessionVideo SessionTelephone (SextPanther)

How long of a session do you wish to book? *1 Hour2 Hours3 Hours4 Hours5 Hours6 Hours7 Hours8 Hours24 Hours/OvernightWeekend/ExtendedNot Applicable (Virtual Session)

Name *

First

Last

Date of Birth *

Residence (City/State) *

Occupation *

References (If Available) *

Experience Level *ExperiencedNovice/Curious

Which of the following statements about you is true? (Select all that apply)

• “I identify as a Masochist.”
• “I identify as a Fetishist.”
• “I identify as a Submissive.”
• “I need to suffer and feel pain for cathartic release.”
• “I suffer for my Mistress because it pleases her. I do not like pain but I endure it because I want to make her happy.”
• “I do not like physical pain or discomfort.”
• “I do not like mental/emotional pain or discomfort.”
• “I do not consider myself to be submissive.”
• “It makes me happy to do things for my Mistress. I enjoy domestic tasks (cooking, cleaning, running errands) because I want to make my Mistress’ life easier.”
• “I believe men do not deserve to feel pleasure. I believe men should be put in chastity and denied release.”
• “Pleasure is an important element to BDSM for me.”
• “Pleasure is not an important element to BDSM for me.”
• “Pleasure is a hard limit.”
• “Pain is a hard limit.”
• “I enjoy BDSM because it helps me get out of my head.”
• “I am new and exploring. I do not know which of these statements are true about myself.”

BDSM Activities – I have tried and enjoy… *

BDSM Activities – I have tried and do NOT care to do again… *

Is there any additional information you would like to share with Lady Vi? *

How did you hear of Lady Vi? *Google/Internet SearchDickie VirginBDSM ProfessionalsSin SearchTrystNews/Podcast/ArticleOther

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