Scale: 5 = This activity is a wild turn-on for me.
               0 = I have no interest, but would do it to please you.
               NO = Hard limit.  I will not participate in this activity at all.

There is also a Word version of this document available.

Activity
As Dominant
As Submissive
Experience
Yes/No
Willingness
NO, 0-5
Experience
Yes/No
Willingness
NO, 0-5
Abrasion    
Age play    
Anal sex    
Anal plugs (small)    
Anal plugs (large)    
Anal plug (public, under clothes)    
Animal roles    
Arm & leg sleeves (armbinders)    
Asphyxiation    
Auction for charity    
Bathroom use control    
Bestiality    
Beating (soft)    
Beating (hard)    
Blindfolds    
Being serviced (sexual)    
Biting    
Breast/chest bondage    
Breath control    
Branding    
Boot worship    
Bondage (light)    
Bondage (heavy)    
Bondage (multi-day)    
Bondage (public, under clothing)    
Brown showers (scat)    
Cages (locked inside of)    
Caning    
Catheterisation    
Cells/Closets (locked inside of)    
Chastity belts    
Chauffeuring    
Choking    
Clothespins    
Cock worship    
Collars (worn in private)    
Collars (worn in public)    
Competitions with other subs    
Corsets (wearing)    
Cross-dressing    
Cuffs (leather)    
Cuffs (metal)    
Cutting    
Dilation    
Double penetration    
Electricity    
Enemas    
Enforced chastity    
Examinations (physical)    
Exercise (forced/required)    
Exhibitionism (friends)    
Exhibitionism (strangers)    
Eye contact restrictions    
Face slapping    
Fantasy abandonment    
Fantasy rape    
Fantasy gang-rape    
Fisting (anal)    
Fisting (vaginal)    
Following orders    
Foot worship    
Forced dressing    
Forced homosexuality    
Forced masturbation    
Forced nudity (private)    
Forced nudity (around others)    
Forced servitude    
Full-head hoods    
Gags (cloth)    
Gags (rubber)    
Gags (tape)    
Gates of Hell (male)    
Genital sex    
Given away to another Dom (temporary)    
Given away to another Dom (permanent)    
Golden showers    
Hairbrush spankings    
Hair pulling    
Hand jobs    
Harems (serving w/ other subs)    
Harnessing (leather)    
Harnessing (rope)    
Having food chosen for you    
Having clothing chosen for you    
Head (fellatio)    
High-heel worship    
Homage with tongue (non-sexual)    
Hot oils (on genitals)    
Hot waxing    
Housework    
Human puppy dog    
Humiliation (private)    
Humiliation (public)    
Hypnotism    
Ice cubes    
Including others    
Infantilism    
Initiation rites    
Injections    
Intricate (Japanese) rope bondage    
Interrogations    
Kidnapping    
Kneeling    
Leather clothing    
Leather restraints    
Lectures for misbehaviour    
Licking    
Manacles & Irons    
Manicures    
Massage    
Medical scenes    
Modeling for erotic photos    
Mouth bits    
Mummification    
Nipple clamps    
Nipple weights    
Oral/anal play (rimming)    
Over-the-knee spanking    
Orgasm denial    
Orgasm control    
Outdoor scenes    
Outdoor sex    
Phone sex (serving Dom)    
Piercing (temporary, play-pierce)    
Piercing (permanent)    
Prison scenes    
Pony slave    
Public exposure    
Pussy/cock whipping    
Pussy worship    
Riding crops    
Riding the "horse" (crotch torture)    
Rituals    
Religious scenes    
Restrictive rules on behaviour    
Rubber/latex clothing    
Rope body harness    
Saran wrapping    
Scratching    
Sensory deprivation    
Serving    
Serving as art    
Serving as ashtray    
Serving as furniture    
Serving as maid    
Serving as toilet    
Serving as waitress/waiter    
Serving orally (sexual)    
Serving other Doms (supervised)    
Serving other Doms (unsupervised)    
Sexual deprivation (short term)    
Sexual deprivation (long term)    
Shaving (body hair)    
Shaving (head hair)    
Sleep deprivation    
Sleepsacks    
Slutty clothing (private)    
Slutty clothing (public)    
Spanking    
Spandex clothing    
Speech restrictions (when, what)    
Speculums (anal)    
Speculums (vaginal)    
Spreader bars    
Standing in corner    
Stocks    
Straightjackets    
Strap-on dildos, sucking on    
Strap-on dildos, penetrated by    
Strap-on dildos, wearing    
Strapping (full-body beating)    
Suspension, upright    
Suspension, inverted    
Suspension, horizontal    
Supplying new partners for Dom    
Swallowing semen    
Swallowing urine    
Swapping, one other couple    
Swapping, multiple couples    
Tattooing    
Teasing    
Tickling    
Triple penetration    
Uniforms    
Vaginal dildo    
Verbal humiliation    
Vibrator on genitals    
Voyeurism (watching others)    
Voyeurism (your Dom w/ others)    
Video (watching others)    
Video (recordings of you)    
Water torture    
Wearing symbolic jewellery    
Whipping    
Wooden paddles    
Wrestling