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Session Contact Form
Thank you for your interest and taking the time to fill out this form. It's the best for both of us to ensure that we maximize our time communicating to create a satisfying and memorable experience together. Please be sure to check your spam folder for a response as sometimes my messages get filtered there.
The information you provide will not be made public and is only seen by Miss Mackenzee.
How do you identify yourself?
What pronouns do you want Me to use with you?
Do you have previous experience? References are preferred. Please list reference contact information as they will be checked.
How did you find Me?
Tickle Media Forum
Length of session (minimum 90 minutes; 24 hours notice required)
When would you like your session? (due to a busy schedule, multiple days/times are appreciated)
Where would you like your session?
Dungeon in Philadelphia
Outcall in Philadelphia
Private Dungeon in Washington, DC area
Outcall in Washingon, DC
What type of session are you looking for? (Can select multiple types)
Age play/adult diaper
Cigar Play/ Human Ashtray
Collar and Leash
Corporal Punishment (Light to heavy)
Domestic Role Play
FT (Toilet Training)
Humiliation/Degradation (Verbal, physical, etc)
Hypnosis (light to full complete control)
Long Leg Worship
Police Officer Role Play
Private/ Educational Sessions
Religious Role Play
Stocking/Pantyhose/Thigh Highs/Garters Fetish
Student/Teacher Role Play
Strap On Worship/Training
What type of mood are you looking to achieve in session? (Can select multiple options)
I'm not sure
List your hard limits and boundaries.
Are marks allowed?
Not at all
Marks lasting no longer than a few hours
Only marks that can be covered by undergarments or bathing suit
Marks can last about a week
I will show off any marks you put on me, Mistress
Are you okay with pictures or videos being taken? Your face will be fully blurred or covered with a hood/mask if you wish. I will respect and honor any response you give.
No, not at all.
Yes, but only of my body
Yes, but please blur/cover my face.
Yes, put all of me on display, Mistress.
Have you been practicing safe social distancing?
Do you wear a face mask when you are around other people?
Have you been in contact with anyone that has tested positive for COVID-19 in the past 14 days?
Do you agree to wear a face mask as I will be wearing one too? I am immunocompromised so it would be required for the duration of our session.
Have you received a COVID-19 vaccine? If yes, please email proof of vaccination.
Health Concerns (Please list any medical concerns here including heart issues, asthma, seizure disorders, joint/mobility issues, surgeries, or STIs. Safety during session is my highest concern. Please note that this information will not be shared with anyone)
Comments. If you selected "other" for any section, please elaborate. Please feel free to ask questions or add any other information you want me to know.
Have you read My cancellation policy on My website? (
To be considered, a copy of your ID must be emailed to
upon completing this form. *Note: you will not receive a response until it is sent.
I will email my ID
I don't want to email my ID
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