Using the form below to request a booking is the fastest way to set up a date. As long as you have included all of the requested information, I will get back to you promptly! Name* First Last Email* Phone Number*No VOIP/burner numbers pleaseOn what website did you find me?*Desired Appointment Date*On what date would you like us to meet?Desired Appointment Time*What time would you like our time together to begin?Desired Appointment Duration*How long would you like us to spend together?Appointment Location*Where would you like the appointment to take place? (My travel radius covers a few states, so please be as specific as possible.)Provider Reference*Provide the email address and website links of two independent providers you've seen within the past 12 months. If you are unable to fulfill this portion of screening, please submit employment verification and/or ID verification below.Verification method*Please select which method of verification you will be using for screening. (Click below.)2 ReferencesID VerificationEmployment VerificationPhoto IDIf you’ve chosen ID verification, use this space to upload a picture of your driver’s license and a recent selfie. Please do not obscure your face or the information on your license. Drop files here or Employment InformationIf you've chosen employment verification, please provide sufficient information to verify your current employment status. This includes an active LinkedIn profile with a photograph connected to your employer, your listing on your company's website, or a company-issued email address. The more information you are able to provide, the easier it will be to verify your identity. (Please do not submit an empty LinkedIn profile you just created with no photo and no connections, or tell me to just search your name on LinkedIn.)CommentIs there anything else I should know to make our appointment go smoothly?I have read Josi's website in its entirety, especially her FAQ, and agree to her cancellation policy.*I mean it, please read it. :) Of course! NameThis field is for validation purposes and should be left unchanged.