Preliminary Application for Surrogate/Gestational Carrier


  • Must be between the ages of 21 and 40 years of age.
  • Must have given birth to at least one child you are raising.
  • Must be in overall good health. BMI must be under 33.
  • Must have had no more than 2 c-sections.
  • Must be free of all sexually-transmitted diseases.
  • Must be a non-smoker and living in a smoke-free environment.
  • Must be willing to undergo a psychological and physical evaluation.
  • Must be willing to have a criminal background check completed on her and spouse/partner.
  • Must be willing to attend counseling sessions throughout the surrogacy process if recommended.
  • Must not be receiving any state or federal government assistance (Medicaid, CHIP, WIC, Food Stamps, etc.).
  • Must have full emotional support from spouse/partner, if applicable.
  • Spouse/partner must agree to undergo a psychological evaluation and medical screening.
  • No serious medical problems during pregnancy or delivery.
  • No pre-term deliveries before 36 weeks (unless in the event of multiples).
  • Must be able to provide us with previous delivery records.
  • Must be cleared by OB.
  • No tattoos or piercings in the last 6-12 months (12 months preceding embryo transfer)
  • Must have a stable residence and not be planning to move out of the state in which the gestational carrier/surrogate lives once accepted into our program
  • Must be financially stable and not depending on surrogate compensation to aid in general living expenses.
- Your phone number shouldn't start with number 1.

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