Risk Profile Designer

Downloadable Formats

Risk Profile Designer (pdf)
Risk Profile Designer (docx)

Instructions

Author’s Note!
This form was originally intended to be used in conjunction with my dungeon safety, and etiquette class “Safety Third!”. It is also possible to use as a standalone document for evaluating and tracking your own Risk Aware Consensual Kink (RACK).

About this form:
This is not meant to be a “Wishlist” or “Outcomes I want checklist! This is meant to serve as examples of what could happen during different types of kink scenes/play. Let me reiterate: All forms of play have some level of risk to the participants. What you accept is up to you.

Start Here!

Name the Form
The large blank space preceding the ‘s Risk Profile Designer is where YOUR, yes you, the reader’s name goes.

Mood
How are you feeling right now? Don’t overthink this.

Expiration Date
Everyone’s medical health, and kink interests change over time. The expiration date here is to remind you that the information on this form is ephemeral.

Section 1: Medical Information
Check any boxes that apply to you. Elaborate using whitespace provided. Use margins for “Other: _____” if necessary.

Section 2, and Section 3: Visible Marks, Non-Visible Marks
The scale ranges from 1 to 10. Where 1 is considered a “Never Acceptable” and 10 is a “Very acceptable”. Circle/Color/Indicate in some fashion your level of acceptance.

Section 2 & 3 Caveats
These scales/ranges are a very simplified scale. For instance some people might be okay with marks in the “t-shirt area”, meaning anything that can be covered by a t-shirt is okay. Use your best judgement. Also note that re

My Risk Profile Suggests…
This section tries to provide guidance on various types of play. All suggestions are based on a Rank 1 (Never acceptable), and it is up to you to interpret the data accordingly. The Risk comments serve as common examples of what could happen and not what will or should happen.

_____________’s Risk Profile Designer

Today I am feeling: _______________ Expires: ______

Section 1: Medical Information

I have one or more of the following:

Heart Condition
Sensitive/Delicate skin
Injury or other restriction: __________________________
Medical Implant/Device: __________________________
Skin Condition/Allergy: __________________________
None of the Above

Section 2: Visible Marks

Rank 1: Never Acceptable | Rank 10: Very Acceptable

Scratches	1	2	3	4	5	6	7	8	9	10
Cuts	1	2	3	4	5	6	7	8	9	10
Bleeding	1	2	3	4	5	6	7	8	9	10
Bruising	1	2	3	4	5	6	7	8	9	10
Black Eye(s)	1	2	3	4	5	6	7	8	9	10
Redness or Skin Irritation	1	2	3	4	5	6	7	8	9	10
Burns	1	2	3	4	5	6	7	8	9	10

Section 3: Non-Visible Marks

Rank 1: Never Acceptable | Rank 10: Very Acceptable

Sore Muscles/Joints	1	2	3	4	5	6	7	8	9	10
Internal Injury/Broken Bones	1	2	3	4	5	6	7	8	9	10
Cognitive/Mental/Emotional	1	2	3	4	5	6	7	8	9	10

My Risk Profile Suggests…

!! IMPORTANT NOTE !!
These are *SUGGESTIONS* and should not be taken as medical or legal advice.
Communicate any issues/concerns you have BEFORE initiating a scene/play, even if it seems trivial. All forms of play can be dangerous, being aware makes it safer.

Strong Recommendations:
- Use common sense!
- Consult your doctor(s) regarding any medical conditions you may have. - Do your best to know your own limitations. - Check in with yourself regularly. Your health, interests and tastes will change over time.

SECTION 1 Responses

Heart Condition

Avoid:

Electrical/Violet wand play.

Risks: Increased chances of triggering cardiac problems. All forms of electricity are
potentially dangerous. Having any voltage run through your body/across your heart could potentially cause a serious medical issue.

Use Caution:

Rough, or very active/energetic scenes

Risks: Increased heart rate. Treat these types of play/scenes the same way you would treat forms of cardiovascular (cardio) exercise.

Sensitive/Delicate Skin

Avoid

See Risks

Use Caution:

Fireplay
Play Piercing/Needles
Impact
Rope

Risks: These types of play have higher chances of leaving marks or damaging your skin. Play piercing/needles especially could result in temporary/permanent scarring.

Injury or Other Physical/Mental Restriction

Avoid:

Injury/Restriction Dependent

Use Caution:

Injury/Restriction Dependent

Risks: Many forms of play may result in further damage to an existing injury. People that have some form of physical or mental restriction may experience new injuries/trauma
if those restrictions are not properly communicated.

Medical Implant/Device

Avoid:

Electrical/Violet Wand

Use Caution:

Implant/Device Dependant

Risks: Any medical device/implant which is connected to the body can be severely
damaged during scenes/play involving electrical stimulation. People with
pacemakers or other heart-related equipment are especially at risk.

Other forms of medical implants/devices may restrict the types of scenes/play depending on the implant/device.

Skin Condition/Allergy

Avoid:

Play Piercing/Needles
Knife play/Sharps
Blood play

Use Caution:

Fireplay
Rope
Impact

Risks: All types of scenes/play where skin is intentionally/accidentally punctured may result in serious infection or illness or other ailments. Needle and Blood play are considered VERY high risk, and should be negotiated as such.

SECTION 2 Responses

Rank 1: Do not want | Rank 10: Best thing Ever

Scratches	Rank 1’s should Avoid: Needles Knife/Sharps Play Reasoning: These forms of play leave marks that will last for hours/days weeks. Rank 1’s should be careful with: Rope Impact Reasoning: Some types of rope (ex: jute, coconut) have a chance to be itchy or leave scratch marks. Likewise, some impact toys, such as single tail whips, may leave scratches.
Cuts	Rank 1’s should Avoid: Needles Reasoning: Needle play is intended to break skin. Rank 1’s should be careful with: Knife/Sharps Play Impact: Single Tails, Dragon Tails, and similar Reasoning: Knife/Sharps Play may result in cuts/skin being broken. Many whips that come to a point or have a single edge may break the skin.
Bleeding	Rank 1’s should Avoid: Needles/Play Piercing Reasoning: Needle play is intended to break skin. Rank 1’s should be careful with: Knife/Sharps Play Impact: Single Tails, Dragon Tails, and similar Reasoning: Knife/Sharps Play may result in cuts/skin being broken. Many whips that come to a point or have a single edge may break the skin.
Bruising	Rank 1’s should Avoid: Impact Takedowns/Roughhousing Reasoning: Impact, and other physically-involved forms of play will often leave bruises or other marks. Rank 1’s should be careful with: Rope Reasoning: Rope, especially rope suspension, carries the possibility to leave bruises where the ropes were wrapped/tied.
Black Eye(s)	Rank 1’s should Avoid: Takedowns/Roughhousing Reasoning: In this instance any form of takedown roughhousing, enthusiastic wrestling, or anything involving flailing limbs could result in facial injuries. Rank 1’s should be careful with: Impact Reasoning: Some toys when used around the shoulders run the risk of wrapping around and hitting parts of the face.
Redness or Skin Irritation	Rank 1’s should Avoid: Fire Play Electrical/Violet Want Needles Knife/Sharps Play Reasoning: These forms of play all involve contact with the skin, and could induce redness, irritation or worse. Many fire or violet wand tops will also apply lotions/ointments to cool the skin down afterward. Rank 1’s should be careful with: Rope Impact Reasoning: Some types of rope (ex: jute, coconut) have a chance to be itchy or leave scratch marks. Likewise, some impact toys, such as single tail whips, may leave scratches.
Burns or Scars	Rank 1’s should Avoid: Fire Play Electrical/Violet Wand Cell Popping Branding Reasoning: Fire Play is perhaps one of the fastest ways to get severe burns. Similarly, electricity is hot. Violet wands carry much less risk of burns but it is still greater than many other forms of play. Cell Popping, and Branding are included only because they are kinks where leaving burn marks/scars are the intended goal. Rank 1’s should be careful with: Needles Knife/Sharps Play Reasoning: Needles, Knifes, Sharps, and anything else that punctures the skin has a chance to leave scarring.

SECTION 3 Responses

Rank 1: Do not want | Rank 10: Best thing Ever

Sore Muscles/Joints	Rank 1’s should Avoid: Impact Takedowns/Roughhousing Reasoning: As an impact bottom you are being hit with implements which may cause soreness. Impact tops may be sore from repetitive use of their implements. Takedowns and/or general roughhousing carry similar risk of soreness as daily exercise (depending upon overall health). Rank 1’s should be careful with: Bondage Mummification/Vacuum beds Reasoning: Extended periods of immobility may cause stiffness in muscles or joints.
Internal Damage/Broken Bones	Rank 1’s should Avoid: Extreme Impact Rope Suspension Reasoning: There are very few, generally practiced, kinks in which a participant may suffer from internal bleeding, organ damage, or even broken bones. However, the possibility still exists. Rank 1’s should be careful with: Impact Takedowns/Roughhousing Electrical/Violet Wand Reasoning: Impact, Takedowns/Roughhousing especially when neck, and lower-back/kidneys could be injured. Electrical and Violet Wand play involves electrical currents running through an individual, and carries the possibility of injury accordingly.
Cognitive/Mental/Emotional	Rank 1’s should Avoid: Humiliation Objectification Reasoning: These forms of play can be mentally or emotionally damaging to the parties involved. *However* it is also possible to negotiate a scene in which an individual wants to relive a trauma or be put into a cathartic emotional state. These types of scenes can be used as a tool for healing mental wounds, but need to be carefully negotiated. Rank 1’s should be careful with: Sensory Deprivation Reasoning: Sensory deprivation may be disorienting and/or include other side-effects.