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Contact Me

Please complete the screening form below to schedule with me.

Name *
Name
Phone *
Phone
Include date, time, and length of appointment you are requesting.
You must select AT LEAST ONE of the screening methods listed below. Bookings that do not include one form of screening will be deleted.
Please include their contact information and link to their website or advertisement.
This must have your name or contact information listed on the website.
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Please email my assistant your photo ID at msbarbaryrose@protonmail.com after completing this form.

 

All messages can be sent to my booking assistant Amy at bookingbarbary@protonmail.com