BDSM Experience and Interests Checklist

(Full Version - revised 10/22)

This Checklist should be filled out by a submissive and provided to their Dom/Top
before playing with them. This will provide a quick “head-start” to identifying limits,
negotiating, and finding common ground for play.
There is intentionally some overlap between categories. Unless otherwise stated, the
sub is the recipient of the item or activity.

For each item or activity, you should provide two answers:

1) In the EXPERIENCE column select YES or NO to indicate if you have ever
actually experienced that item or activity.
2) In the WILLINGNESS or DESIRE column indicate for each item or activity how
you FEEL about participating with/in that item or activity (if you have selected
YES) or how you THINK you would feel about participating with/in that item or
activity (if you have selected NO), by rating it on a scale of 0 to 5.

 5 – The item/activity is a wild turn-on for you, and you would like it as often as possible.
 4 – You like this item/activity, and would like to experience it on a regular basis.
 3 – You sometimes like this item/activity, at least on an occasional basis.
 2 – You are willing to participate in this item/activity, but it has no special appeal for you.
 1 – You have utterly no interest or desire for this item/activity and don’t (or wouldn’t) like
doing it (in fact, you may loath it) and would ordinarily object to it, but you would be
willing to do it to please your Dom if they really wanted it. (Sometimes called a Soft
Limit)
 0 – You will NOT participate in this item/activity under any circumstances. (Hard Limit)

Note any additional information that might be important for (or that you WANT) your
Dom to know in the comments box. And please keep in mind that when an item or
activity is listed on this Checklist, that does NOT necessarily imply that the Dom has
any interest in that item/activity.

Submissive:______________________ Date:_______________
 Experience? Willingness or Desire

Item or Activity Yes No 0 1 2 3 4 5 Comments

Abrasion ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
After-care ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Age Play ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Anal:
Beads ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fingering ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Sex ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Plug (small) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Plug (large) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Plug (public, under clothes) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Vibes, Toys, etc. ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Animal Roles ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Arm Sleeves (binders) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Bathroom use control ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Bestiality ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Beating (soft) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Beating (hard) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Being Bitten ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Blindfolds ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Blood Play ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Breath Control ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Branding ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Boot Worship ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Bondage:
Hands in Front ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hands Behind ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hands over Head ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Ankles ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Knees ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Elbows ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Wrists-to-Ankles ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Wrists-to-Waist ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Rope ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tape ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Metal Cuffs ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Leather Cuffs ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item or Activity
Silk Ties ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
Zip Ties ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Spreader Bars ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tied to a Chair ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tied to a Bed ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tied to Another Person ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Public – in Full View ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Public - Hidden ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Public – Under Clothes ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Breast Bondage ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Breast Whipping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cages (locked inside) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Candle Wax ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Caning ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Catheterization ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Chastity Belt ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Choking ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Clamps:
Nipples ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Genital ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Other Areas ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Closets/cells (locked inside) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Clothespins ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cock Sucking ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cock Worship ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Collars (worn in private) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Collars (worn in public) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Condom Use ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Corsets ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Creampies – Anal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Creampies – Vaginal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cuckold (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cuckold (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cunnilingus (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cunnilingus (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cupping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Dancing (for Dom) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item (exhibitionist)
Dancing or Activity ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
Depilation/Shaving ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Diapers ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Dildo:
Anal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Clit ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Mouth ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Vaginal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Double Penetration:
2 cocks ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
2 toys ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Combo – cock & toy ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Enemas ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Enforced Chastity ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Examinations (physical) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Exercise (forced/required) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Exhibitionism (for Dom) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Exhibitionism (for strangers) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Eye Contact Restrictions ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Face slapping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fantasy Abandonment ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fantasy Kidnapping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fantasy Rape ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Felching ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Figging ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fire Play ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fisting – Anal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Fisting - Vaginal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Flogging ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Following Orders ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Foot Worship (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Foot Worship (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Forced:
Bisexuality ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Dressing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Exhibitionism ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Masturbation ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item
Nudityor Activity ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
Servitude ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Weight loss/gain ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Full Head Hoods ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Gags:
Cloth ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Metal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Phallic ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Rubber ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tape ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Given away to another
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Dom (temporary)
Given away to another
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Dom (permanent)
Gloryhole ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Grooming (Dom) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hair Pulling ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hand Jobs ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Harems (serving with other ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
subs)
Harnesses ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Having clothing chosen ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Having food chosen ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hickeys or Bite Marks ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
High Heel Worship ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Homage (with tongue, full ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
body)
Hot Waxing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Housework ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Humiliation (verbal, private) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Humiliation (verbal, public) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hypnotism ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Ice cubes ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Infantilism ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Initiation Rites ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Interracial ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Interrogations ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Kissing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Kneeling ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item
Knife Playor Activity ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
Latex Gloves ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Leash – Private ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Leash – Public ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Leather Clothing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Leather Restraints ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Lingerie ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Lectures for misbehavior ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Manacles & Irons ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Marks:
Visible in street clothes ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Visible in bathing suit ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Totally Hidden ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Massage (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Massage (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Medical Play ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Modeling (for Dom) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Modeling (for Others) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Monogamy (with Dom) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Mummification ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Needle Play ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Nipple:
Clamps ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Stimulation ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Torture ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Weights ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Orgasm Control ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Orgasm Denial ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Outdoor Scenes ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Outdoor Sex ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pegging ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Phone Sex (with Dom) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Phone Sex (with Dom’s ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
friends)
Photography (pics of you) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Piercing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pinching ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pissing:
 Experience? Willingness or Desire
Item or(onActivity
For Dom command) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
In Public (exhibitionism) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
On Someone ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
During Sex ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Being Pissed On ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Being Pissed In (anal) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Being Pissed In (vaginal) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Being Pissed In (mouth) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Polyamory ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pony Slave ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Public Exposure ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Punching ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pussy Slapping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pussy Whipping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pussy Worship (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Pussy Worship (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Remote controlled vibrator ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Riding Crops ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Rimming (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Rimming (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Rituals ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Restrictive Rules ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Rubber/Latex Clothing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Role Playing:
Boss/Employee ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Daddy/Daughter ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Doctor/Patient ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hotel Room Service ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Prostitute ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Teacher/Student ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Other ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Saran Wrapping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Scening in Public ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Scratching (giving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Scratching (receiving) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Semen:
Drinking ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item or Activity
In Mouth ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
On Body ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
On Face ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Swallowing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Sensory Deprivation ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Serving As:
Art ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Ashtray ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Furniture ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Maid ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Toilet ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Waitress/waiter ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Serving other Doms ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
(supervised)
Serving other Doms ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
(unsupervised)
Sex During Menstruation ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Sexual Deprivation (short ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
term)
Sexual Deprivation (long ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
term)
Shaving (body hair) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Shaving (head hair) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Sleep Deprivation ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Sleep Sacks ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Slutty Clothes (private) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Slutty Clothes (public) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Spanking:
Bare ass ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Bare Hand ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Belt/Strap ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Bent Over (furniture) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Cane ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Crop ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Flogger ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Hairbrush ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Kneeling ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Lying Down ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Over-the-knee ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item
Paddleor Activity ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
Standing (upright) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Standing (grab ankles) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Spandex Clothing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Specified Grooming ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Speculums – Anal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Speculums - Vaginal ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Speech Restrictions ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Standing in Corner ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Stocks ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Straitjacket ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Strap-on (sucking on) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Strap-on (penetrated by) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Strap-on (wearing, using) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Strapping (full body beating) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Suspension (upright) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Suspension (inverted) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Suspension (horizontal) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Supplying Additional
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Partners for Dom
Swapping Partners (with ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
another couple)
Swinging (multiple couples) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tattooing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Teasing ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
TENS Unit (electrical) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Threesome – MFM ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Threesome – FMF ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Thumb Cuffs ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Tickling ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Triple Penetration ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Uniforms ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Vaginal Sex ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Violet Wand (electrical) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Voyeurism (watching others) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Voyeurism (watching Dom ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
with others)
Videos (watching porn) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Videos (recordings of you) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
 Experience? Willingness or Desire
Item
Water or Activity
Torture ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments
Wearing Symbolic Jewelry ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Whipping ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Wrestling ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Other: (write-ins) ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐
Additional Items, Activities,
Remarks, or Requests: