APPLICATION
 Decided you're ready to take the next step and schedule a session with Mistress Simone?  Here is your opportunity to tell Her what, specifically, you are seeking. Take some time and fill out the application in its entirety.  It will aid Mistress Simone in scheduling and tailoring your session.

 NOTE: Completion of this application does not guarantee session time availability.  Mistress Simone will respond to your application and request for specific dates and times.  Also please note, this application is designed to aid you in the first step of contacting Mistress Simone and is not a substitute for Her session guidelines.  If this is to be your first session, you must still speak with Mistress Simone via phone.

Phone: 773-991-3908 / Email: MsSimone@Chicago-Mistress.com
Phone Hours: 10am - 10pm CST Seven days a week
Please respect hour limits.

APPLICATION

Name 

E-mail Address 

City : Chicago or St Louis 

Session Time Requested 

Session Time Requested 

Length of Session 

 

Anal Play (Receiving Only)         
 

Ashtray Service
 

Blindfolds                              

 

Boot Worship                        

 

Canes                                  

 

Candle Wax                          

 

Catheters                             

 

Chastity Devices                    

 

Clamps                                 

 

Clothespins                           

 

CBT                               

 

Collars
 

Cross-dressing (Light)
 

Electric Play
 

Enemas
 

Face Slapping
 

Feminization
 

Fire Play
 

Fisting
 

Foot Torment to you
 

Foot Worship to Mistress

 

Floggers
 

Gags
 

Genital Bondage
 

Golden Showers
 

Hairbrush Punishment
 

Hair pulling
 

Hair removal/Shaving
 

Hoods
 

Interrogation Scenes
 

Infantilism
 

Latex
 

Maid Service
 

Medical Exam
 

Mummification
 

Needles
 

Nipple Torment
 

Paddles
 

Plaster Mummification
 

Role Play  

 

Type of Role Play  

 

Saline Injections
 

Sensory Depravation
 

Smoking by Mistress
 

Smothering
 

Sounds
 

Spanking               

 

Spitting                 

 

Temperature Play    

 

Tickling                  

 

Trampling               

 

Vacuum Pumps        

 

Verbal Humiliation   

 

Vibrators                

 

Weights                 

 

Whipping               

Misc. Information

 

Are bruises/marks acceptable?   
 

Other fetishes not listed 

 

Preference of Mistress scene attire (nude is NOT an option) 

 

Possible health issues or limitations         

 

IMPORTANT NOTE: I am not a stripper, a dancer, or a prostitute turned Mistress. You are contacting a serious Mistress who is selective in her clients and enjoys her lifestyle. If you are not a sincere submissive or fetishist, submissive, or masochist, please try elsewhere. This is not a factory assembly line. It is a private dungeon with an experienced Mistress who likes and cares about her submissives.
NO ESCORT, NO MASSAGE, NO DRUGS and NO PROSTITUTION.
END OF DISCUSSION!
ATTENTION Visiting Dominas:
If you are interested in studio space, please feel free to contact me.