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Sexual Consent Form

This document is a sexual consent form and privacy agreement between two parties over 18 years old. It specifies that certain sexual acts will occur by mutual consent, with provisions to stop at any time by safeword. It also agrees the form will remain private, except in cases of sexual misconduct accusations, to protect privacy. Signatures of both parties are required to consent to the agreement.

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Christopher Kurtis Koeber
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1K views

Sexual Consent Form

This document is a sexual consent form and privacy agreement between two parties over 18 years old. It specifies that certain sexual acts will occur by mutual consent, with provisions to stop at any time by safeword. It also agrees the form will remain private, except in cases of sexual misconduct accusations, to protect privacy. Signatures of both parties are required to consent to the agreement.

Uploaded by

Christopher Kurtis Koeber
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Sexual Consent Form

&
Right of Privacy Agreement

I, ________________________________, hereby declare under penalty of perjury


that I am over 18 years old.

I further declare that this agreement is of my own free will and that neither I nor
anyone near or dear to me has been threatened with harm or embarrassment.

Both parties agree that this is a private agreement not to be disclosed to third
parties except in case of accusation of sexual misconduct by the agreeing party. If
he/she shows or makes public this agreement without accusation of sexual
misconduct, it is agreed that he/she will be liable for damages for invasion of
privacy.

By initialing, _____ I agree to engage in all or some of the following consensual acts.
HERE

Sexual fondling and kissing


Oral copulation (mutual)
Oral copulation (unilateral) by _____________________only
Sexual intercourse with an FDA approved condom at all times

Other consensual sexual conduct to be specified:


___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

I further declare that I am at this time not under the influence of alcohol, drugs or
medication and agree to engage in consensual sex with:
__________________________________

At this time I do not intend to change my mind before the sex act or acts are over.
However, if I do, it is further understood that when I say the words “CODE RED” my
partner agrees to STOP INSTANTLY!

Signed: _________________________ Date: __________________________

Signed: _________________________ Date: ____________________________

Disclaimer: Check with your attorney before entering into any agreement.

© 2006 Dr. Ava Cadell. All rights reserved.


www.avacadell.com

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