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Customer Booking Questionnaire
Only 2 Minutes to Get Ready to Meet!
Fill in our questionnaire to ensure a smooth booking. Make your booking in a short second and bring the right escort to the right place at the right time.
🟢*Denotes Required Field
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* Indicates required question
Email
*
Your email
🟢 Mail address
(reconfirm)
*
Your answer
🟢 How to meet
*
Delivery
Rendezvous
🟢 Name
(alias name accepted)
*
Your answer
🟢 Mobile Phone No.
*
Your answer
Name of Hotel
Your answer
Room no
Your answer
Hotel Address
Your answer
🟢 Requested Date
*
MM
/
DD
/
YYYY
🟢
Requested Session
*
Delivery to home (Airbnb included): 90 minutes or more
Delivery Area over 3000 yen: 90 minutesor more
Delivery Area over 4000 yen/5000 yen: 120 minutes
or more
Delivery Area over 6000 yen: 180 minutes or more
Choose
70 min (Rendezvous)
90 min (Rendezvous/Delivery)
120 min (Rendezvous/Delivery)
150 min (Rendezvous/Delivery)
180 min (Rendezvous/Delivery)
🟢
Time
*
Business hours 12 pm ～ 3 am
Time
:
AM
PM
🟢 Payment
*
Cash
🟢
Your Japanese
*
Cannot speak
Broken
Native
Your English
Cannot speak
Broken
Native
Clear selection
🟢 Nationality
*
Your answer
Ethnicity
Your answer
🟢 How did you find us ?
*
BBS
Job site
Search Engine
Friend referral
Facebook
Other:
Please enter your Search Engine Keyword
ex. osaka massage
Your answer
Message
Your answer
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