Booking — Madame Ume

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Madame Ume

Madame Ume

booking Form

COMPLETE THE FORM BELOW TO REQUEST A BOOKING. YOU CAN ANTICIPATE A RESPONSE IN 24-48 HOURS.

New Donation request rates listed below are effective as of june 12, 2024. Return Clients - please contact me directly if you’d like to retain your previous donation request rate when re-booking the same type of session.

Preferred name(S) *

Pronouns *

Email *

Phone

optional. specify if you prefer text, whatsapp, or signal

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location *

INCALL: Oakland, CA

INCALL: SAN FRANCISCO, CA

OUTCALL: SF BAY AREA, please specify WHICH CITY in "scheduling" field below

Virtual consultation: text, VOICE, or video

Scheduling *

Please list specific dates and times you are available

Type of session *

BDSM/Kink - 90 min - $500 DONATION

FBSM - 1 hr - $300 DONATION

FBSM+ - 1 HR - $400 donation

additional hour(s) - $300/HR DONATION

VIRTUAL Consultation - please describe below to receive a quote

CASH MEET - $100 deposit + $200 minimum tribute

Dinner & Domination - 3 hrs - $1200 donation ($400 deposit)

Desires

What are you hoping to experience? are there specific kinks you would like to explore? how do you want to feel during or after your session?

What are your hard limits? boundaries?

Do you have any medical conditions I should be aware of? (chronic pain, heart condition, latex allergy, STI, ect.) Do you have any accessibility needs? *

screening: Will you provide photo id, OR proof of employment, or references from other providers for screening? *

Couples - only one person needs to complete this form, but screening is required for both people

yes

no

Thank you! We’ll be in touch as soon as we can.

With regards to California Penal Code section 647(b) and CALCRIM Nos. 1153 to 1155, the services discussed herein do not in any way include or relate to either (1) engagement in any lewd act for money or other consideration, or (2) solicitation, offer, or agreement to engage in any lewd act for money or other consideration. I do not offer illegal activities.