Thank you for your interest in our Surrogacy Program. We know the decision to be a Surrogate can be both exciting and scary! You likely have questions about what to expect. Hopefully, you have already reviewed the resources on our site and have a solid understanding of what it means to be a Surrogate. If you have not, please review the information provided under our Blog: For Surrogates

We are currently looking for Surrogates who reside in the following states: Alabama, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Maryland, Massachusetts, Minnesota, Nevada, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Texas, or Wisconsin. 

Once you submit your Potential Surrogate Intake form, a member of our team will contact you to gather additional information and answer any questions you may have about the next steps. Surrogacy laws vary by state, so if you live in a state other than what is listed above and are still interested, feel free to submit an interest form and we will contact you regarding your options.

 

Before starting your application, we ask you to review the acknowledgements below:

  • I have access to my insurance policy and am comfortable sharing this information with My Donor Connection
  • I have access to my medical records and am comfortable sharing all OB records with My Donor Connection
  • I have had at least one pregnancy and delivered full term without complications
  • I understand I will undergo medical screening to determine my eligibility to be a Surrogate
  • I understand that I, along with my partner, will undergo psychological screening to determine my eligibility as a Surrogate 
  • I understand I must have reliable transportation to get me to and from medical appointments
  • I understand and am comfortable with taking medications over the course of several months (medication can be in the form of injection, suppository, patch or pill)
  • I consent to a background check being performed on myself and my partner 
  • I understand I must not smoke, drink or use illegal drugs and have a healthy BMI between 18- 33
  • I understand the emotional nature of donating to a recipient couple and am committed to act responsibly and will take care of my physical and emotional health

Congratulations - you are offering another couple an amazing gift.  We will be in touch shortly after a member of our team receives notification of your interest!

Your Name (required)

Address

Your Email (required)

Primary Phone Number (required)

Date of Birth

Height

Weight

Number of pregnancies carried full term:

Did you experience complications with any pregnancy or delivery?

Any other information you would like to share at this time?