EmailMeForm
Book Now
Please use this form to make your reservations with our providers.
Name
*
First
Last
Email
*
Note: be sure that this email address is secure.
Phone
*
###
-
###
-
####
Note: be sure that this phone number is secure.
Provider
*
Whom would you like to meet with?
Date and Time (choice 1)
*
MM
/
DD
/
YYYY
HH
:
MM
AM
PM
AM/PM
When would you like to meet? (1st choice)
Date and Time (choice 2)
*
MM
/
DD
/
YYYY
HH
:
MM
AM
PM
AM/PM
When would you like to meet? (2nd choice)
Call Type
*
Choose below
In-call
Out-call
Out-call Location
If call type is out-call, please provide the address.
Appointment Length
*
Choose below
1 hour
1.5 hours
2 hours
3 hours
More than 3 hours
Client Verification
*
Choose below
Room Service 2000
Preferred 411
Date Check
Other Agency
None
Please identify the use of any verification services or other agencies used.
Registration Name
*
Your name listed with any of the above verification services. Enter "none" if you are not listed with a verification service.
Home City
*
Your city listed with any of the above verification services. Enter "none" if you are not listed with a verification service.
Verification Phone
*
Your phone listed with any of the above verification services. Enter "none" if you are not listed with a verification service.
By clicking on the Submit Reservation button below, that action indicates that you have read and accept all policies, terms and conditions and everything else featured on chicagocovergirls.com.
Additionally, your appointment is not officially confirmed until you have received a confirmation email and phone call from our talent manager.