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Companion Appointment Form

I understand that Micky Lynn's Executive Touch and the companion have the right to cancel/end/refuse any appointment not following the agency guidelines.

I'm requesting to see a companion through Micky Lynn's Executive Touch and have not experienced any form of solicitation in anyway.

Please make sure you know our Rates before completing our appointment form. The appointment form is for 2 to 24 hour notice prior for all bookings.

If you need to CANCEL and/or CHANGE your appointment, please let us know at least an hour prior.

* Indicates required field

First Name: *

Age: *

Date of Birth: MM/DD/YYYY *

Occupation: *

The phone number & email address provided below will be used to confirm your appointment, if we CAN NOT reach you. We will cancel your scheduled appointment.

Phone Number: *

Best time to reach you? *

Can we leave a message? *

Email *

How did you learn about us? *

Name of advertisement: *

Companion *

Desired Date: MM/DD/YYYY *

State: *

In or Out *

Desired Length: *

Desired Time: *

Home or Hotel Information Required

Please provide Micky Lynn's Executive Touch with the address where our companion will be meeting you. This can be your home or hotel, if you are staying at a hotel it must be registered under your name.

Hotel Name: *

Home or Hotel Address: *

Apt/Room #: *

City: *

State: *

Zip Code: *

Incomplete forms missing ANY information CAN NOT be processed.

When you have verified that all the information you provided to Micky Lynn's Executive Touch Agency is correct, please click the SUBMIT BUTTON.

Thank you & We hope to meet you real soon!

Yours Truly,
Micky Lynn's Executive Touch

I agree to receiving marketing and promotional materials *

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Privacy Policy

Micky Lynn's Executive Touch is a Companion Service Provider Only and in exchange for advertising/setting appointments for the independent contractor. Our agency will introduce two or more consenting adults for the sole purpose of Companionship either in public or private. Anything other than this is by personal choice between adults of legal age.

All companion(s) are 18 years old or older, proof of age on file and have an Adult Entertainment Identification Card from Palm Beach County Florida. We DO NOT tolerate human trafficking and will report anyone who is being exploited.

NO SEXUAL ACTIVITIES ARE IMPLIED OR CONDONED BY MICKY LYNN'S EXECUTIVE TOUCH AND COMPANION