Let’s Get to Know You

♡ Thank you for being generous and taking your time to fill this out. Your responses help us better understand you and allow us to move forward correctly and respectfully regarding medical requirements and compensation♡

2. Have you been a surrogate before? *

7. Social Media

9. Are you a U.S. citizen or permanent resident? *
12. What is your marital status? *
15. Are your menstrual cycles generally regular? *
19. Have you ever delivered a baby before 36 weeks of pregnancy? *
20. Have you experienced any pregnancy or delivery complications, before, during, or after? (Please select all that apply) *
21. Have you had any miscarriages or abortions? *
22. Have you had any new tattoos or piercings within the past 12 months? *
23. Have you ever been diagnosed with any of the following? (check all that apply) *
24. Are you currently taking any medications or supplements? *
25. Do you smoke or vape nicotine? *
26. Do you drink alcohol? *
27. What birth control method are you currently using? *
28. Are you currently working? *
29. Do you have a strong support system during pregnancy? *
30. Is your partner/spouse supportive of surrogacy (if applicable)?
31. Are you afraid of needles or injections? (The medical process involves injections, especially during the transfer cycle, so we want to make sure you feel prepared and supported) *
32. When would you like to start your journey? *