To book an appointment to meet me, please fill in the form below.

Alternatively you can contact me at the following E-Mail. Please Note that prior screening is required in order to secure a meeting. This is for safety and security reasons only; no private information is ever shared with third parties. This information is strictly confidential.


Full Name:


Phone number:

Ok to leave voicemail or text?

Yes, either is fineVoicemail onlyText onlyNeither

Preferred Method of Contact

EmailPhoneNo Preference

Resident City

Screening Service

If you are a member of the following screening service, please provide the necessary details I need to verify you.

Preferred 411

Companion References

Please provide the name, email, website address and contact number for at least two reputable companions you have spent time with within the last 3 months.

Reference #1

Reference #2

Employment Information

Please provide your employment information below

Company Name


Company Website

Company Phone Number

Your Direct Line or Extension

Phone etiquette or cover to use when calling

Appointment Details

Please outline your appointment preferences below.

Requested Date


Location Address

Miscellaneous Information

How did you find me?

Is there anything else you would like to tell me?

Aurora Escort & Companion

Aurora Escort & Companion