Screening Form

If we have met before, no deposit is required.  Just send me a PM.

This form is for those WITH and WITHOUT provider references. This form is NOT for P411 members.

New clients without reputable provider references must pay a $20 screening fee + processor's fee in order for me to begin screening you for an appointment.  This screening fee will go toward your appointment and the remaining balance will be due in cash when you arrive.  If you flake, cancel, or no-show, the screening fee is non-refundable and will not be returned. This is due prior to screening.  Do not initiate screening unless you have a date and time in mind of when you'd like to meet me.  The easiest way to pay the deposit is via cashapp, but I also accept the deposit via https://youpay.me/NovaLuxx (click blue "youpayme now" button).


If you ghost after screening, you will be put on my permanent "do not see list".

I am newbie friendly.  Please be honest with all information required below.

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I do not contact providers for references. Screenshots are required if you have provider references. Attach your screenshot of Provider #1 Vouch, thank you after visit, etc. below. If you do not have any references, just drop any image below.  If you have no references, you must pay the $20 screening deposit.

I do not contact providers for references. Screenshots are required if you have provider references. Attach your screenshot of Provider #2 Vouch, thank you after visit, etc. below. If you do not have any references, just drop any image below.  If you have no references, you must pay the $20 screening deposit.

Please note:  A phone is required for arriving to my place for your appointment. I do not give my address or directions to my place, etc by email or PM.  Do not contact me, go through screening, and book an appointment, if you are unable to call me when you arrive to the location near me.  I do not give my number out until I text you to confirm the appointment and give location details.