Booking

Below you will find my booking form that I request you fill out in as much detail as possible to ensure I can provide you with the best experience possible. I also ask that you familiarise yourself with my Etiquette page before requesting a booking with me. Thank you in advance and I cannot wait to hear from you!

    Your Details

    Full Name:

    Email:

    Telephone Number:

    Appointment Details

    Date of Booking:

    Time of Booking:

    • :

    Duration:

    Incall/Outcall

    Please provide your location name and address:

    Please provide the full destination address, including country:

    Screening

    For screening to be completed you must select 2 of the following 4 screening options, for example: Companion References and Work Email, or ID plus LinkedIn Profile.

    1. Companion References
    Minimum of 2 references from companions you have visited in the last 12 months. Name, website, email + phone number.

    Companion reference 1:

    Companion reference 2:

    2. ID

    Please provide a copy your photo ID (passport or drivers license):
    Note that I will ask to see this at the beginning of our date to check that it is a match.
    Max file size is 2mb

    3. LinkedIn Profile

    Please provide a link to your professional LinkedIn profile URL:

    4. Work Email

    Send me an email to rebeccaheartness@gmail.com directly from your work email address, enter the email address you will use here:

    Additional Information

    Where did you hear about me?

    If other, please state below:

    Please enter the directory name below:

    Would you like to share your picture with me? If yes, please upload.
    Max file size is 2mb

    Comments / questions / requests...