|
BDSM Activities
Negotiation Questionaire
|
|
General Questions
and Information
|
|
What is your level of experience? Very experienced Experienced Limited experience Beginner |
What do you believe the purpose of pain is in a session? Pain is a punishment Pain is a reward Whatever pleases my partner Not sure |
|---|---|
|
What is your sexual orientation? Heterosexual exclusively
Bisexual
|
Sex (intercourse, oral) in a scene for me is….. An enhancement
Not necessary or expected
|
|
What is your Gender?
Male Female TG / TS / TV |
Who can know of your activities?
No one A very few trusted friends Other scene people Doesn't matter who knows |
|
Your main Interest : Sensual and physical
Psychosexual and mental
|
Which settings are you comfortable playing in? Public play
Scene parties
One on one
|
|
What is your level of pain (what are you looking for) Pain slut
|
Your level of interest in bondage is: Total helplessness
|
|
When it comes to sex or intimacy I'm a slave and love it
|
What kind of relationship do you prefer? Long term, live in
|
|
Are you? (rate each from 1-10, one being the least) |
|
Sadistic ----- 1
2
3
4
5
6
7
8
9
10
Masochist -- 1
2
3
4
5
6
7
8
9
10
Dominant --- 1 2 3 4 5 6 7 8 9 10 Submissive - 1 2 3 4 5 6 7 8 9 10 |
|
Is there anything you would like to add? |
|
The Art of Role-playing
|
|
Listed below are several
examples of roles to be played by either Dominants or submissives. Please
list the examples that interest you. Then
list the examples you would like your partner to play.
|
|
Amazon Baby Barbarian Bitch-Goddess Boss Burglar Child Clergy Cowboy Cowgirl Daddy DoctorEvil PriestEvil Priestess Femme Fatale |
French maid God Goddess Hooker Indian Inquisitor Interrogator Hero Kidnap Victim Knight Leather Man Master Mentor Mistress Mommy |
Nun Nurse Rapist Role Reversal Pet Pimp Pirate Policeman Ponygirl Ponyboy POW Prince Princess Principal Puppy |
Savage Secretary Sex Object Sissy Slave Slave Owner Slut Student Suspect Teacher Teen Torturer Victim Warrior Wild Beast |
|
I would like to
play
|
I would like my
partner to play..
|
|
|
|
|
Please list any specific
fetishes you have. (example: foot worship, latex)
|
|
|
|
List any medical, physical, or emotional concerns. (example: past breaks, phobias, diabetes) |
|
|
|
List your HARD LIMITS. (what you won't do no matter what) |
|
|
|
List your concerns about the depth and exclusivity of a relationship. |
|
|
|
List your preferred method of birth control and avoidance of STD's |
|
|
|
Below are 6 parts of the body and 3 activities that can be done safely. Using the codes, rate them at what you would be comfortable experiencing. |
|
Letter Code
|
|
N = Never T = Thuddy S = Stingy L = Light
M = Medium H = Heavy ? = Unsure N/A = No Way |
|
Part of the Body
|
Bondage Tied to a bed etc. |
Corporal Spanked, caned |
Torture
Cock/ball etc |
|
Back / Shoulder
|
|
|
|
|
Bottom/ Thighs
|
|
|
|
|
Breast / Chest
|
|
|
|
|
Genitals
|
|
|
|
|
Feet / Ankles
|
|
|
|
|
Hands / Wrists
|
|
|
|
|
Activity/Interest
List
|
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Enter either/both a D (Dominant) or
S (submissive) (to distinguish which activities you like to do in which
mode).
|
Then enter the number (or symbol)
indicating your level of interest in the middle spot .
|
Finally, put an X to indicate which
activities you have tried
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Bondage (arms, legs, wrist,
feet)
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Silk Scarves |
|
|
|
|
Rope (nylon, cotton, hemp)
|
|
|
|
|
Rope (nylon, cotton, hemp)
|
|
|
|
|
Leather (cuffs, ties)
|
|
|
|
|
shackles (wrists, ankles)
|
|
|
|
|
Arm sleeves
|
|
|
|
|
Chains
|
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Bondage (body or body parts)
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Spandex bonds |
|
|
|
|
Plastic wrap
|
|
|
|
|
Straight jackets
|
|
|
|
|
Chastity belts
|
|
|
|
|
Body bags
|
|
|
|
|
Gags (ring, cloth, bit, ball)
|
|
|
|
|
Genital bondage
|
|
|
|
|
Breast bondage
|
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Bond Too Items
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Ceiling hooks
|
|
|
|
|
Wall hooks |
|
|
|
|
Slings or Swings
|
|
|
|
|
Stocks or Pillory
|
|
|
|
|
Crosses or T-Bars
|
|
|
|
|
Suspension on toes
|
|
|
|
|
Full suspension
|
|
|
|
|
Spreader bar
|
|
|
|
|
Cages
|
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Time & Setting
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Public
|
|
|
|
|
Semi-Public
|
|
|
|
|
Private group
|
|
|
|
|
Private one on one
|
|
|
|
|
1-3 hour duration
|
|
|
|
|
3-6 hour duration
|
|
|
|
|
Over night duration
|
|
|
|
|
Outdoors
|
|
|
|
|
Indoors |
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Dress and Adornment
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Macho
|
|
|
|
|
Slave
|
|
|
|
|
Child / baby
|
|
|
|
|
French maid
|
|
|
|
|
Uniform
|
|
|
|
|
Domina
|
|
|
|
|
Ultra-Feminine
|
|
|
|
|
Prim and Proper
|
|
|
|
|
Slutty
|
|
|
|
|
Conservative
|
|
|
|
|
High Heels
|
|
|
|
|
Symbolic jewelry
|
|
|
|
|
Biker / Leathers
|
|
|
|
|
Spandex
|
|
|
|
|
Rubber / Latex
|
|
|
|
|
Masks / Hoods
|
|
|
|
|
Boots
|
|
|
|
|
Corsets / Cinches
|
|
|
|
|
Garters / Stockings
|
|
|
|
|
Lingerie
|
|
|
|
|
Costumes
|
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Humiliation / Exhibition
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Verbal Abuse
|
|
|
|
|
Dirty words
|
|
|
|
|
Lead on a leash
|
|
|
|
|
Crawling
|
|
|
|
|
Kneeling
|
|
|
|
|
Foot kissing
|
|
|
|
|
Public sex
|
|
|
|
|
Shaving
|
|
|
|
|
Medical examinations
|
|
|
|
|
Symbolic jewelry
|
|
|
|
|
Public displays
|
|
|
|
|
Secret sex in public
|
|
|
|
|
Public embarrassment
|
|
|
|
|
Name calling
|
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Corporal Activities
|
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Spanking (by hand)
|
|
|
|
|
Leather paddles
|
|
|
|
|
Wooden paddles
|
|
|
|
|
Floggers |
|
|
|
|
Yard Stick
|
|
|
|
|
Strap
|
|
|
|
|
Interest Codes
|
| 1 = YES (pant, drool} |
| 2 = Mmmmmm, I like |
| 3 = Doesn't excite me, but I will |
| 4 = Absolutely not |
| # = Intriguing, but scary |
| ! = Embarrassed to admit it |
|
Torture and Sensory Play |
Dom or Sub?
|
Intrested?
|
Tried Before?
|
|
Mummification
|
|
|
|
|
Breath play
|
|
|
|
|
Straight jacket
|
|
|
|
|
Blindfolds
|
|
|
|
|
Hoods
|
|
|
|
|
Headphones / Ear-plugs
|
|
|
|
|
You can save this form by
clicking "File", "Save As" Name
the file and save to your documents.
|