Negotiation Worksheet
Negotiation Long Form
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, audio tapes or videotapes)? Explanation:
2. Roles
Who will be dominant?
Who will be submissive?
Type of scene:
master/slave mistress/slave captive servant/butler/Etc.
cross-dressing/gender play age play animal play other
Any chance of switching roles? Explanation:
Will the submissive promptly obey? Explanation:
May the dominant "overpower" or "force" the submissive? Explanation:
May the submissive verbally resist? Explanation:
May the submissive physically resist? Explanation:
Does resistance equal a "strong yellow"? Explanation:
May the submissive try to "turn the tables"? Explanation:
Does the submissive agree to wear a collar? Explanation:
The submissive agrees to address the dominant by the following title(s):
3. Place/Location
Who will ensure privacy?
4. Time
Begin at: __________ Length: _____________________________
Beginning signal?
Ending signal?
Who will keep track of time?
5. Oops
Does everybody involved understand that there is some risk of accident, miscommunication, misperception and/or unintentional injury?
Does everybody involved agree to discuss any mishaps in a constructive and non-blaming manner?
6. Limits
Submissive's Limits:
Submissive's physical/emotional/SM activity limits:
Any problems with the submissive's:
- heart?
- lungs?
- neck/back/bones/joints?
- kidneys?
- liver?
- nervous system/mental?
- Explanation?
Is the submissive wearing contact lenses?
Does the submissive suffer from carpal tunnel syndrome or related problems?
Does the submissive have a history of:
- seizures?
- dizzy spells?
- diabetes?
- high/low blood pressure?
- fainting?
- asthma?
- hyperventilation attacks?
Describe any phoias:
Submissive's other medical conditions:
Any surgical implants (breasts, face, etc.)? Explanation:
Is the submissive taking aspirin?
Is the submissive taking ibuprofen, Aleve, or other non-steroidal, anti-inflammatory drugs?
Is the submissive taking antihistamines?
Other medications submissive is taking?
Allergic to:
- bondage tape?
- nonoxynol-9?
- Other allergies?
In case of emergency notify?
Dominant's Limits:
Dominant's physical/emotional/SM activity limits:
Any problems with the dominants:
- heart?
- lungs?
- neck/back/bones/joints?
- kidneys?
- liver?
- nervous system/mental? Explanation:
Dominant's other medical conditions?
Medications dominant is taking?
In case of emergency notify?
Is the dominant currently certified in First Aid/CPR?
Safety gear on hand:
- paramedic scissors?
- flashlight?
- first aid kit?
- blackout light?
- fire extinguisher?
Will the play be in an isolated area such as a farmhouse?
If yes, what will ensure the submissive's safety if the dominant becomes unconscious?
- no bondage to chair, bed, etc.?
- no gag?
- silent alarm?
- third person present?
- telephone/radio/panic button within the submissive's reach?
- Other?
7. Sex
Does any participant believe they might have a sexually transmitted disease? Explanation:
Does any participant believe they might have herpes? Explanation:
Have participants been tested for HIV?
Has any participant tested positive? Explanation:
Which of the following sexual acts are acceptable?
Masturbation: _____ dom to sub _____ sub to dom
_____ Self-masturbation by submissive
_____ Self-masturbation by dominant
Fellatio: _____ dom to sub _____ sub to dom
Cunnilingus: _____ dom to sub _____ sub to dom
Analingus: _____ dom to sub _____ sub to dom
Anal fisting: _____ dom to sub _____ sub to dom
Vaginal fisting: _____ dom to sub _____ sub to dom
Vaginal intercourse: _____ dom to sub _____ sub to dom
Anal intercourse: _____ dom to sub _____ sub to dom
Is swallowing semen acceptable?
Is any participant menstruating?
Will sex toys such as vibrators, dildoes, butt plugs, etc. be used?
Describe:
Which of the above activities will involve birth control pills, diaphragms, spermicidal suppositories, lubricants containing nonoxynol-9, or contraceptive foam/suppositories/gel?
Which of the above activities will involve condoms, gloves, dental dams, and/or other barriers?
8. Intoxicants
The dominant can use (only) what intoxicants during the session:
Acceptable quantity?
The submissive can use (only) what intoxicants during the session?
Acceptable quantity?
9. Bondage
The submissive agrees to allow (only) the following types of bondage:
- hands in front?
- hands behind back?
- ankles?
- knees?
- elbows?
- wrists to ankles (hog-tie)?
- spreader bars?
- tied to chair?
- tied to bed?
- use of blindfold?
- use of gag?
- use of hood?
- use of rope?
- use of tape?
- use of handcuffs/metal restraints?
- use of leather cuffs?
- suspension?
- mummification with plastic wrap, body bag or similar techniques?
- Any past bad experiences by either person with bondage, gags, blindfolds, and/or hoods?
10. Pain
Submissive's general attitude about receiving pain:
___ likes ___ accepts ___ neutral ___ dislikes ___ will not accept
Quantity of pain submissive wants to receive:
_____ none _____ small _____ average _____ large
Explanation:
Dominant's general attitude about giving pain:
___ likes ___ will give ___ neutral ___ dislikes ___ will not give
Quantity of pain dominant wants to give:
_____ none _____ small _____ average _____ large
Explanation:
Will the "now" technique be used? Explanation:
Will the "nod" technique be used? Explanation:
Will the "one to ten" technique be used? Explanation:
The following types of pain are acceptable:
- spanking?
- paddling?
- whipping?
- caning?
- face slaps?
- biting?
- nipple clamps?
- genital clamps?
- clamps elsewhere? locations?
- hot creams?
- ice?
- hot wax?
- tickling?
- Other types/methods of pain?
- Additional remarks?
11. Marks
Is it acceptable to the submissive if the play leaves marks?
Visible while wearing street clothes?
Visible while wearing a bathing suit?
Other?
Is it acceptable to the submissive if the play draws small amounts of blood? Explanation?
How easy or difficult has it been to mark the submissive in the past?
12. Erotic Humiliation
The submissive agrees to accept being referred to by what terms?
The submissive agrees to the following forms of erotic humiliation:
- "verbal abuse"?
- enemas?
- forced exhibitionism?
- spitting?
- water sports?
- scat games?
- Other?
Any prior really good or really bad experiences in these areas?
13. Safewords
Safeword #1 and its meaning?
Safeword #2 and its meaning?
Safeword #3 and its meaning?
Non-verbal safewords and their meanings?
Will "two squeezes" be used?
Will the "extended hand" technique be used?
14. Opportunities/Special Skills
Anything in particular either party would like to try or explore?
15. Follow-Up
(Please include a note about who will initiate contacts.)
After the session?
The next day?
A week later?
In case of a crisis?
16. Anything else?
What will become of this form after the session?
Post Session Notes (one to ten scale, ten highest)
Dominant:
- Overall feeling?
- Best part?
- Worst part?
- Other comments?
Submissive:
- Overall feeling?
- Best part?
- Worst part?
- Other comments?
Copyright 1996 by Jay Wiseman, SM101, reprinted with permission
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