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    <!-- #REDIRECT [[Session negotiation]] -->
#REDIRECT [[SM-101 Form]]
<center><big>'''''Scene Negotiation Checklist from SM 101 by Jay Wiseman'''''</big>
{{Header|SM101 Form 12/20}}
<br>
'''This form is presented in plain text so that it can be printed out:'''</center>
<hr>
<PRE>
Perhaps not all will apply to our scene, but do answer the questions honestly and openly, for this will help me in making your experience wonderful.
 
  1. People
          * Who will take part?
          * Who will watch? (Note: The session will involve only those people specifically named above.)
          * Will any permanent record be made of the session (photographs, video, audiotapes?
                o Yes
                o No
                o Explanation:
  2. Roles
          * Who will be dominant?
          * Who will be submissive?
          * Type of scene:
                o Mistress/Slave
                o Captive
                o Servant/Butler/Etc
                o Cross-dressing/gender play
                o Age play
                o Animal play
                o Other
          * Any chance of switching roles?
                o Yes
                o No
                o Explanation
  3. Place
          * Location
          * Who will ensure privacy?
  4. Time
          * Begin at:
          * Lenth:
          * Beginning signal:
          * Ending signal:
          * Who will keep track of time?
  5. Obedience
          * Will submissive promptly obey?
                o Yes
                o No
                o Explanation
          * May the dominant "overpower" or "force" the submissive?
                o Yes
                o No
                o Explanation
          * May the submissive verbally resist?
                o Yes
                o No
                o Explanation
          * May the submissive physically resist?
                o Yes
                o No
                o Explanation
          * May the submissive try to "turn the tables"?
                o Yes
                o No
                o Explanation
          * Does the submissive agree to wear a collar?
                o Yes
                o No
                o Explanation
          * The submissive agrees to address the dominant by the following titles:
  6. Limits
          * Submissive's limits
                o Submissive's physical/emotional/SM activity limits:
                  Any problems with the submissive's:
                      + Heart
                            # Yes
                            # No
                      + Liver
                            # Yes
                            # No
                      + Lungs
                            # Yes
                            # No
                      + Neck/Back/Bones/Joints
                            # Yes
                            # No
                      + Kidneys
                            # Yes
                            # No
                      + Nervous System/Mental
                            # Yes
                            # No
                      + Explanation
                o Is the submissive wearing contact lenses?
                      + Yes
                      + No
                o Does the submissive have implanted pace maker?
                      + Yes
                      + No
                o Does the submissive have any metal plates implanted?
                      + Yes
                      + No
                o Drug Metering Pumps?
                      + Yes
                      + No
                o Does the submissive have a history of....
                      + Seizures
                            # Yes
                            # No
                      + Dizzy Spells
                            # Yes
                            # No
                      + Diabetes
                            # Yes
                            # No
                      + Hypoglycemia
                            # Yes
                            # No
                      + Seizures Disorders
                            # Yes
                            # No
                      + Known Brain Wave Abnormalities
                            # Yes
                            # No
                      + High Blood Pressure
                            # Yes
                            # No
                      + Fainting
                            # Yes
                            # No
                      + Asthma
                            # Yes
                            # No
                      + Heart Rhythm Oddities
                            # Yes
                            # No Explanation
                      + Hyperventilation attacks
                            # Yes
                            # No
                      + Describe any [[phobia]]s:
          * Submissive's medical conditions: Any surgical implants (breast, face, etc?)
                o Yes
                o No
                o Explanation
          * Is the submissive taking asprin?
                o Yes
                o No
          * Is the submissive taking ibuprofin, Motrin, or other non-steroidal, anti-infammatory drugs?
                o Yes
                o No
          * Is the submissive taking antihistamines?
                o Yes
                o No
          * Other medications submissive is taking:
          * Allergic to;
                o Bandage tape:
                      + Yes
                      + No
                o Nonoxynol-9
                      + Yes
                      + No
                o Other allergies:
                o In case of emergency notify:
          * Dominant's Limits
                o Any problems with the dominant's:
                      + Heart-
                            # Yes
                            # No
                      + Liver
                            # Yes
                            # No
                      + Lungs
                            # Yes
                            # No
                      + Neck/Back Injuries
                            # Yes
                            # No
                      + Bones/Joints
                            # Yes
                            # No
                        Kidneys
                            # Yes
                            # No
                      + Nervous System/Mental-
                            # Yes
                            # No
                      + Heart Rhythm Oddities-
                            # Yes
                            # No
                      + Seizure Disorders
                            # Yes
                            # No
                      + Implanted Pace Maker-
                            # Yes
                            # No
                      + Drug Metering Pumps-
                            # Yes
                            # No
                      + Does the Dominant have any metal implants?
                            # Yes
                            # No
                      + Known Brain Wave Abnormalities-
                            # Yes
                            # No
                      + Dominant's other medical conditions:
                      + Medications dominant is taking:
                      + Is the dominant currently certified in First Aid and CPR-
                            # Yes
                            # No
                      + Safety gear on hand: Paramedic scissors:
                            # Yes
                            # No
                      + Fire extinguisher:
                            # Yes
                            # No
                      + First Aid Kit:
                            # Yes
                            # No
                      + Blackout lights:
                            # Yes
                            # No
                      + Flashlight:
                            # Yes
                            # No
                      + Will play take place in an isolated area such as a farmhouse or other location?:
                            # Yes
                            # No
                      + If yes, what precautions will ensure the submissive's safety if the dominate becomes unconscious?
  7. Sex
          * Are you Male?
                o Yes
                o No
          * Are you Female?
                o Yes
                o No
          * Are you a TS?
                o Yes
                o No
          * if yes- pre-op
                o Yes
                o No
          * post-op
                o Yes
                o No
          * Age:
          * Marital/Relationship Status:
                o Monogamus:
                o Sneaking behind partners back:
                o Polyamory:
          * Occupation:
          * Height:
          * Weight:
          * Hair Color:
          * Eye Color:
          * Facial Hair?
          * Charactistics (things you'd like known about you, physically):
 
          * Does any participant believe they might have a trichomonas or yeast infection
                o Yes
                o No
                o Explanation:
          * Does any participant believe they might have herpes?
                o Yes
                o No
                o Explanation:
          * Does any participant believe they might have any STD?
                o Yes
                o No
                o Explanation:
          * Does any participant believe they might have Hepititis?
                o Yes
                o No
                o Explanation:
          * Have participant been tested for HIV?
                o Yes
                o No
          * Been tested positive?
                o Yes
                o No
                o Explanation:
 
          * Check off which of the following sexual acts are acceptable:
                o Masturbation
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Fellatio
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Cunnilingus
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Rimming
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Anal Fisting
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Vaginal Fisting
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Vaginal intercourse
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Anal intercourse
                      + Dominant to Submissive
                      + Submissive to Dominant
                o Is swallowing of semen acceptable
                      + Yes
                      + No
                o Will any sex toys such as vibrators, dildoes, butt plugs, ben wa balls, etc be used?
                      + Yes
                      + No
                o Describe:
 
                      + Which of the above activities will involve birth control pills, diaphragms, spermicidal suppositories, lubricants containing nonoxynol-9, or contraceptive foam/suppositoried/gel?
                      + Which of the above activities will involve condoms, gloves, dental damns, and/or other barriers?
                o Intoxicants
                      + The dominant can use (only) the following intoxicants during the session:
                            # Acceptable quantity:
                      + The submissive can use (Only) the following intoxicants during the session:
                              Acceptable quantity:
 
          * Bondage
                o The submissive agrees to allow (only) the following types of bondage:
                      + Hands in front
                            # Yes
                            # No
                      + Hands behind
                            # Yes
                            # No
                      + Ankles
                            # Yes
                            # No
                      + Knees
                            # Yes
                            # No
                      + Elbows
                            # Yes
                            # No
                      + Wrists to ankles(hog-tie)
                            # Yes
                            # No
                      + Spreader bars:
                            # Yes
                            # No
                      + Tied to Chair
                            # Yes
                            # No
                      + Tied to bed
                            # Yes
                            # No
                      + Use of blindfold
                            # Yes
                            # No
                      + Use of gag
                            # Yes
                            # No
                      + Use of hood
                            # Yes
                            # No
                      + Use of rope
                            # Yes
                            # No
                      + Use of handcuffs/metal restraints
                            # Yes
                            # No
                      + Use of tape
                            # Yes
                            # No
                      + Use of leather cuffs
                            # Yes
                            # No
                      + Suspension
                            # Yes
                            # No
                o Acceptable degree of immobility/helplessness:
                      + Limited
                      + Moderate
                      + Extreme
                      + Explanation
          * Pain
                o Submissive's general attitude about receiving pain:
                      + Likes
                      + Accepts
                      + Neutral
                      + Dislikes
                      + Will not accept
                o Quantity of pain submissive wants to receive:
                      + None
                      + Small
                      + Average
                      + Large
                      + Explanation:
                o Dominant's general attutude about giving pain:
                o Quantity of pain dominants wants to give:
                      + None
                      + Small
                      + Average
                      + Large
                      + Explanation:
                o The following types of pain are acceptable:
                      + Spanking
                            # Yes
                            # No
                      + Paddling
                            # Yes
                            # No
                      + Whipping
                            # Yes
                            # No
                      + Caning
                            # Yes
                            # No
                      + Face slaps
                            # Yes
                            # No
                      + Biting
                            # Yes
                            # No
                      + Nipple clamps
                            # Yes
                            # No
                      + Gential clamps
                            # Yes
                            # No
                      + Clamps elsewhere
                            # Yes
                            # No
                            # Locations:
                      + Hot creams
                            # Yes
                            # No
                            # Locations:
                      + Ice
                            # Yes
                            # No
                            # Locations:
                      + Hot Wax
                            # Yes
                            # No
                            # Locations:
                      + Other types/methods of pain:
                      + Additional remarks:
 
          * Marks
                o Is it acceptable to the submissive if the play leaves marks?
                            # Yes
                            # No
                      + Visible while wearing street clothes?
                            # Yes
                            # No
                      + Visible while wearing a bathing suit?
                            # Yes
                            # No
                      + Other:
 
                o Is it acceptable to the submissive if the play draws small amounts of blood?
                      + Yes
                      + No
                      + Explanation:
 
                o How easy or difficult has it been to mark the submissive in the past?
                o Erotic Humiliation
                      + The submissive agrees to accept being referred to by the following terms:
                      + The submissive agress to the following forms of erotic humiliation:
                            # "Verbal abuse"
                                  * Yes
                                  * No
                            # Enemas
                                  * Yes
                                  * No
                            # Spitting
                                  * Yes
                                  * No
                            # Water Sports
                                  * Yes
                                  * No
                            # Scat games
                                  * Yes
                                  * No
                            # Other:
                      + Any prior really good or really bad experiences in these areas?
                o Safe Words
                      + Safe Word #1 and its meaning
                      + Safe word #2 and its meaning
                      + Safe word #3 and its meaning
                      + Non-verbal safe words and their meaning
                      + Will "two-squeezes" be used?
                            # Yes
                            # No
                o Opportunities/Special Skills
                      + Anything in particular either party would like to try and explore?
                o Dominant
                      + Which statement best suits you:
                            # I live D/s lifestyle every day in most activities:
                            # I live D/s lifestyle frequently when in relationship:
                            # I live D/s lifestyle occasionally in relationship:
                            # I live D/s lifestyle in "scenes" or "play" only:
                            # I use D/s only in "scenes" or "play":
                            # I do not live D/s lifestyle but would with correct sub:
                            # I would not live D/s lifestyle but would use for "play" with correct sub
                            # (Other statement which best suits you):
                      + Are you interested in:
                            # On-Line Relationship ONLY:
                            # On-Line/Phone Relationship ONLY:
                            # Real Time Relationship ONLY:
                            # On-Line/Phone/Real Time Relationship Combination:
                            # Do you currently have a sub/slave:
                            # Are you currently seeking a sub/slave:
                            # Would you take on "multiple subs":
                            # Can or would you travel to meet/be with a sub:
                            # Would you have a sub travel to meet you:
                      + Are you experienced with:
                            # On-Line D/s:
                            # Phone D/s:
                            # Real Time D/s:
                      + Previous Relationships:
                      + Have you ever had a "collared" sub:
                            # On-Line Only:
                            # Real Time:
                            # (Why did that relationship terminate, current relationship with that sub
          * D/s SOCIAL:
                o Would you expect a sub to perform the following and if so, how often:
                  (Rating scale: "O" (occasionally). "F" (frequently). "A" (at all times when applicable).
                      + Kneeling (clothed):
                      + Kneeling (naked):
                      + Wearing bondage outside "scenes" (crotch ropes, etc.):
                      + Wearing toys outside "scenes" (nipple clamps, etc.):
                      + Wearing toys/bondage in public:
                      + "Correct posture" outside "scenes" (define):
                      + Sexual situations in public:
                      + Wearing D/s collar in public:
                      + Wearing D/s collar in private:
                      + Performing "instructions" (delivered on-line or phone):
                o Would you require a standard form of dress for the sub in private (if so, what):
                o Would you require a standard form of dress for the sub in public (if so, what):
                o What form of address would you expect from the sub for youself and others (check applicable):
                      + Yourself:
                            # Sir:
                            # Master:
                            # First name:
                            # Mr. (last name):
                            # Mistress
                            # Ma'am
                            # Domina
                            # First Name
                            # Ms
                            # Ms (last name)
                      + Other Males:
                      + Other Females:
                      + Both Dom/Dommes and subs...in and out of BDSM
                o What aspects of your subs' life would you want to control (check all applicable):
                      + Choice of clothing:
                      + Choice of food:
                      + Daily activities:
                      + Special occasion activities (non-sexual):
                      + Sexual activities:
                      + Social contacts:
                      + Sleeping hours:
                      + Bathing/toilet rituals:
                      + Business/professional life:
                o Would you desire to "share" your sub with others:
                      + Yes
                      + No
                o (If "YES", state the circumstances and likely other partners) Would you wish your sub to have any of the following (check applicable):
                      + Tattoo of ownership:
                      + Branding of ownership:
                      + Collar (or bracelet) worn constantly:
                      + Screen name change to reflect ownership:
                o List any "scene" or "play" activities which you WOULD NOT DO under any circumstances:
          * PUNISHMENTS:
            What forms of punishments would you use on a disobedient sub:
                o Writing assignments:
                o Meditation:
                o Corporal Punishment (spanking, whipping, etc.):
                o Bondage (any form):
                o Removal of privilages:
                o Loss of Contact with you:
                o Withholding orgasms/pleasure:
                o Other (please state):
          * REWARDS:
                o What forms of rewards would you give a pleasing sub:
                      + Small "presents" (flowers, etc.):
                      + Extra privilages:
                      + Additional "play":
                      + Personal momentos (inc. letters to her, etc.):
                o More about you:
                      + Non-D/s Interests/Hobbies:
                      + Favorite Music Types:
                      + Favorite Reading:
                      + Favorite Non-D/s Leisure Time Activities:
                      + Any other information you would like to supply regarding yourself:
          * Submissive
                o Which statement best suits you:
                      + I live D/s lifestyle every day in most activities:
                      + I live D/s lifestyle frequently when in relationship:
                      + I live D/s lifestyle occasionally in relationship:
                      + I live D/s lifestyle in "scenes" or "play" only:
                      + I use D/s only in "scenes" or "play":
                      + I do not live D/s lifestyle but would with correct Dom:
                      + I would not live D/s lifestyle but would use for "play" with correct Dominant:
                      + (Other statement which best suits you):
                o Are you interested in:
                      + On-Line Relationship ONLY:
                      + On-Line/Phone Relationship ONLY:
                      + Real Time Relationship ONLY:
                      + On-Line/Phone/Real Time Relationship Combination:
                      + Do you currently have a Dom/Top/Owner:
                      + Are you currently seeking a Dom/Top/Owner:
                      + Can or would you travel to meet/be with a Dominant:
                o Are you experienced with:
                      + On-Line D/s:
                      + Phone D/s:
                      + Real Time D/s:
                o Previous Relationships:
                o Have you ever been collared?
                o Why did that relationship terminate?
                o Whats your current relationship with that Dominant?
                o Have you had previous relationships:
                      + Real life:
                      + Only On Line:
                o What aspects of your life would you want your Dominant to control (check all that apply)
                      + Choice of clothing:
                      + Choice of food:
                      + Daily activities:
                      + Special occasion activities (non-sexual):
                      + Sexual activities:
                      + Social contacts:
                      + Sleeping hours:
                      + Bathing/toilet rituals:
                      + Business/professional life:
                o Would you desire to be "shared" with others:
                      + Yes
                      + No
                      + Shared with:
                      + Female Dominates:
                      + Female submissives:
                      + Male Dominants:
                      + Male submissives:
                o Would you have any of the following done for your Dominant:
                o Check those that apply
                      + Tattoo of ownership:
                      + Branding of ownership:
                      + Collar (or bracelet) worn constantly:
                      + Screen name change to reflect ownership:
                o List any "scene" or "play" activities which you WOULD NOT DO under any circumstances:
                o More about you:
                      + Non-D/s Interests/Hobbies:
                      + Favorite Music Types:
                      + Favorite Reading:
                      + Favorite Non-D/s Leisure Time Activities:
                      + Any other information you would like to supply regarding yourself:
  8. Follow-Up
      After the session we need a coming down period
      The next day we should discuss how things went
      A week later follow-up
      In case of crisis:
      Anything Else?
      Post-session notes:
          * Dominant
                o Best Part 1-10 scale(ten tops)
                o Worst Part 1-10
                o Most memorable part 1-10
                o Other comments:
          * Submissive
                o Best part 1-10
                o Worst Part 1-10
                o Most memorable 1-10
                o Other comments
 
 
*********************************************************************************************************
 
(This is a form that should be filled out by both dom(me) and sub...it gives you both a starting place) Please answer these question completely honestly. Please use a separate sheet/s of paper if necessary.
 
  1. What sexual fantasies have you had that relate to s/m?
 
  2. What is it about yourself that arracts you to the s/m play scene?
 
  3. Describe a scene you would find to be highly erotic, satisfying and descriptive of the role you wish to assume in s/m.
 
  4. Describe a scene you would fine completely out of bounds or off limits as fas as your current disposition and understanding are concerned.
 
  5. List erotic toys and devices you currently own.
 
Disclaimer:
By filling this form out and returning it, I am doing so with full knowledge and with a competent mind. It is my understanding that the form is used for social purposes only and for my benefit. I also understand that the persons or persons who are to be handling the form will do so with confidentiality and with no malicious intent. I am stating that I am over the consenting age of the state that I live in and I am an adult. By submitting this form I release all liability and do so at my own risk.
 
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