Prescreen Request

Hello and thank you for visiting my sensual world. In order to gain access to my full site and ability to schedule time with me, prescreening is required.

You might ask why is this step necessary? I would like to keep our future online interactions discrete as your privacy is important to me. In order to do that I need to give you a personal login ID. Before I can give you that I need to make sure that you are who you say you are and not some teenager trying to get ahold of my pictures .

If you have seen me before and don't have a login, please email me at ananda@anandahealer.com or click here and fill out my in page email form. That method is ONLY for people who have successfully screened with me before. If you have not, I will just direct you back to this form so please do not try to short cut this process.

I have four screening methods. Please select the one that works best for you:

Simple online screening: Provide me with your real personal information via the form below. Please allow one business day so that I may verify the information you provide.
In person meeting: For this option there is a $50 fee for my time and travel. If you are not comfortable with your personal information being sent to me on the Internet, use this option to request a in person meeting. Please allow time for scheduling a day for this meeting and you will be expected to provide the same information as the online screening when in person along with photo ID.
Reference screening: If you would rather use existing provider references, I do require two provider references. They must be established local providers with a web presence. Please allow up to three business days for me to contact them.
Preferred411: If you are not comfortable giving me your information directly, I do accept Preferred411 as a reference. This is a paid service that functions completely independent of me but they will handle your verification and all you need to provide me is your Preferred411 ID.

Online Screening
Legal Name:
Date of Birth:
Functional Phone Number: --
E-Mail Address:
Nickname:
How you found me:
Please note that you will also be required to bring your legal ID to your first in person meeting and show it to me.
In Person Meeting
Nickname:
E-Mail Address for scheduling:
Phone Number: --
  (for day of meeting only)
How you found me:
Please note that you will also be required to bring your legal ID to your first in person meeting and show it to me.
I will do background check after our meeting and contact your email with web site login info for future scheduling.
Provider Reference Screening
Nickname:
E-Mail:

First Provider's Information
Name they know you by:
Email they know you by:
Phone number they know:
Provider's Name:
Provider's E-mail:
Provider's Website Link:
Tell me something they will remember about you and when you last saw them:

Second Provider's Information
Name they know you by:
Email they know you by:
Phone number they know:
Provider's Name:
Provider's E-mail:
Provider's Website Link:
Tell me something they will remember about you and when you last saw them:
PLEASE, allow 1-3 business days for me to reach out and for them to respond. Please, remember they are offering a reference as a courtesy, and let them know to expect my email (not phone or text). They are being generous with their time, and I request we be friendly and patient with their response time.
Preferred411 Screening
What is Preferred411? It's a 3rd party paid vetting service at www.preferred411.com. It has a $129.00 annual fee.
Preferred411 ID:
Nickname:
E-Mail: