Dear Sir and/or Madam:

I would like to express my deepest gratitude for your willingness to begin the process of considering having sex with me. A few brief matters of federal, state, and local law—both civil and criminal—before we go any further.

  1. Please initial here____, and sign below, to certify that neither your blood alcohol level nor mine is at or above .08%, and that, to your certain knowledge, neither of us is under the influence of any mind altering drugs, whether illicit, prescribed, borrowed from a friend's medicine cabinet, or purchased over the internet.
  2. Verify that you are over the legal age of consent in all fifty states, US territories, and the Schengen Area, and that your gender is as represented. (Attach documentation to Appendix A.)
  3. My medical files are attached (in Appendix B), certifying that, as of 9PM EDT today, I am free of sexually transmitted diseases, mono, strep, or pneumonia. (Biometric, retina scan, identity confirmation available through either iPhone or Android app). Please attach your medical files, using Appendix C.
  4. Regarding sexually transmitted disease prophylaxis, the above certification notwithstanding, please select preference order from the following list: male condom; female condom; both; full wet suits—flippers optional (see psychiatric addendum to my medical Appendix B).
  5. Please indicate the birth control method you are using here: __________________. A. What is your rate of birth control use, as a percentage of times you have engaged in sexual activity? B. Have you experienced more than two birth control failures? If yes, please complete Competency Quiz in Appendix D.
  6. Are you: A. Presently involved in a putatively monogamous relationship? B. Presently involved in a consensually polyamorous relationship? C. Presently or recently involved with a sexual partner with anger issues and/or a history of violence? D. Do you now have, or have you had in the past, anger issues and/or do you have a history of violence? (Please attach relevant medical, legal, or psychiatric documentation to Appendix E)
  7. Do you have sexual fetishes, preferences, hang-ups, limits, interests, or problems of which I should be aware? (Attach to Appendix F; my own interests available on line or via either iPhone or Android app.)
  8. Please indicate with whom and to what degree details of our sexual activities may be shared via (but not limited to) letters, phone calls, email, Twitter, social media, blogging, posting of pictures, audio, or video—whether live or on delay—domestically or internationally.

Please certify with your signature below, under the penalties of perjury, providing two notarized copies, one for each of us: that you have accurately and completely answered all of these questions and provided full and true supporting information and documentation; that you hold me legally and morally harmless for any actions I may take based on errors or omissions, whether intentional or unintentional, on your part; and that you remain interested in moving forward with pursuing a sexual encounter with me, freely and for non-commercial purposes (for which, again, I am deeply grateful).

OK: Let's. Get. It. On!