SURVEY
Mistress Elektra BDSM Interest Evaluation
dear slaves: highlight survey, copy and paste to a word document and fill in what suites you and email it to me (fillable form on its way) EMAIL TO: STRICTMISTRESS4HOUSTON@gmail.com.
Name: ________________________ Scene Name: _____________________
Please highlight all that apply to you: Are you a: Top Switch Bottom
Do you play: Light Moderate Heavy Gender: Female Male Transsexual Intersex
Sexual Orientation: Gay Bisexual Heterosexual Asexual Pansexual Questioning
Do you have any specific boundaries in BDSM, being touched, and/or in sex?
On the following tables, indicate your preferences for each item. Feel free to add an item under “Other:” if you don’t see an activity in the lists.
Role Play
| Fantasy Role Play Scenes | Like | Unsure | Dislike |
| Knife Edge Play | |||
| Emotional Edge Play | |||
| Hot / Cold Play | |||
| Humiliation Play | |||
| Daddy-Child Scene | |||
| Mommy-Child scene | |||
| Rape Scene | |||
| Medical Play | |||
| Interrogation Scene | |||
| Business Office Scene | |||
| Teacher / Head Master – Pupil Scene | |||
| Nun / Priest Scene | |||
| Pirate Scene | |||
| Inquisition Scene | |||
| Sensory Depravation Scene | |||
| Master / Slave Scene | |||
| Doctor / Nurse – Patient Scene | |||
| Human Pony / Horse | |||
| Food Play | |||
| Being Put On Display | |||
| Other: |
Medical Scene Activities
| Medical Activities | Like | Unsure | Dislike |
| Saline Injections | |||
| Needle Play | |||
| Speculum | |||
| Urethral Sounds | |||
| Urethral Vibrators | |||
| Enemas | |||
| Catheter | |||
| Neurowheel | |||
| Forceps | |||
| Dental Play | |||
| Pelvic Examination | |||
| Straight Jacket | |||
| Other: |
BDSM Toys
| Type of Toy | Like | Unsure | Dislike |
| Collar | |||
| Leash | |||
| Paddle | |||
| Flogger | |||
| Leather Belt | |||
| Riding Crop | |||
| Quirt | |||
| Bull Whip | |||
| Cat-o-Nine Tails | |||
| Clothes Pins | |||
| Clothes Pins Zipper | |||
| Clips | |||
| Clamps | |||
| Dildos | |||
| Vibrating Dildos | |||
| Strap-on Dildo | |||
| Butt Plugs | |||
| Vibrators | |||
| Anal Beads | |||
| Chastity Device | |||
| Human Horse Gear | |||
| Corset | |||
| Cock Ring | |||
| Ball Collar | |||
| Neurowheel | |||
| Tethers | |||
| Ball Gag | |||
| Blindfold | |||
| Leather Head Hood | |||
| Leather Wrist Restraints | |||
| Leather Ankle Restraints | |||
| Spreader Bar | |||
| Hand Cuffs | |||
| Leg Cuffs | |||
| Bondage Rope | |||
| Slapper | |||
| Nipple Clamps | |||
| Nipple Vibrators | |||
| Ball Crusher | |||
| Penis Vacuum Pumping | |||
| Other: |
Dungeon Equipment
| Types of Equipment | Like | Unsure | Dislike |
| St. Andrews Cross | |||
| Spanking Bench | |||
| Restraining Chair | |||
| Restraining Table | |||
| Chain Station | |||
| Stocks | |||
| Rope Bondage Station | |||
| Full Body Suspension Station | |||
| Examination Table | |||
| Sling | |||
| Cage | |||
| Medieval Stretching Rack | |||
| Dentist Chair | |||
| Examination Chair with Stirrups | |||
| Other: |
BDSM Activities
| Types of Activities | Like | Unsure | Dislike |
| Bondage | |||
| Body Worship | |||
| Spanking | |||
| Body Modification | |||
| Temporary Piercing | |||
| Body Piercing | |||
| Temporary Scarification | |||
| Temporary Tattoos | |||
| Permanent Tattoos | |||
| Human Branding | |||
| Exhibitionism | |||
| Voyeurism | |||
| Foot Fetish | |||
| Women’s Panties | |||
| Women’s Undergarments | |||
| Golden Showers | |||
| Brown Showers | |||
| Scat Play | |||
| Cross Dressing | |||
| Nipple Torture | |||
| Hot Wax | |||
| Fire Play | |||
| Cupping | |||
| Flash Cotton | |||
| Electronic Play | |||
| Tens Unit | |||
| Violet Wand | |||
| Strangulation | |||
| Mummification | |||
| Other: |
Body Modification
| Type of Body Modification | Like | Unsure | Dislike |
| Penis Enlargement (Vacuum Pump) | |||
| Nipple Enlargement (Vacuum Pump) | |||
| Clitoris Enlargement (Vacuum Pump) | |||
| Foreskin Restoration | |||
| Ball Stretcher | |||
| Genital Piercing | |||
| Urethral Enlargement (Sounds) | |||
| Tattoos | |||
| Branding |
Receiving Anal Sex:
_____ Unprotected Anal Sex _____ Unprotected Anal Sex Without
Ejaculation
_____ With the Use of Sex Toys _____ Sex Toys With a Protective Barrier
_____ Anal Penetration With a Protective _____ Use of Fingers Without Protective
Barrier Worn On The Penis Barriers
_____ Use of Fingers With Protective _____ Fisting Without Protective Barriers
Barriers
_____ Fisting With Protective Barriers _____ I Do Not Receive Anal Sex Play
From Others
Have you ever contracted a Sexually Transmitted Disease and if so, please list them?
Tell me your BDSM Fantasy (and I will tell you IF I can successfully make it come true)