Surrogates 2018-01-08T18:16:02+00:00

Want to become a Surrogate Mother?

Robin admires your compassion in applying to become a gestational surrogate mother and helping a family to have a child.

FIND OUT WHETHER YOU QUALIFY TO BECOME A GESTATIONAL SURROGATE.

Surrogacy

To become a gestational surrogate, you must meet all of these requirements:

  • Be between 21 and 43 years old
  • Enjoy being pregnant and have had at least one healthy, normal pregnancy and delivery
  • Have no serious medical problems
  • Be a non-smoker
  • Use no illegal substances
  • Have a body mass index (BMI) equal to or less than 32
  • Have emotional support for your surrogacy from your family and others close to you
  • Be financially stable and not on food stamps or public assistance
  • Have reliable transportation and be willing to travel, if necessary, for screening, matching with intended parent, and medical testing
  • Be willing to undergo medical and psychological evaluations, and any spouse/significant other should be willing to undergo the same
  • Have no criminal history

To find out if you qualify, fill out this form or contact Robin with your questions:

First Name *

Last Name *

Your Email *

Your Birth Date
Month *

Day *

Year *

Phone Number * (numbers only incl. area code)

Mailing Address/Place of Residence *
Street Address
Street Address Line 2
City
State
Zip Code

Height * (feet, inches)

Weight *

Number of Children *

Number of Pregnancies *

Number of Cesarean-sections (C-sections) *

Length of time carried each pregnancy (in months) *

Have health insurance? (If yes, name of insurance carrier) *

Please list any complications with any pregnancies *

What is your financial status? *

Have you ever applied be a gestational surrogate at any other medical facility, law firm, and/or agency and been told that you do not meet the facility’s criteria to be a gestational surrogate? *
NoYes

List all serious illnesses and hospitalizations (or enter NONE if appropriate) *

List all medications you are presently taking and the reasons for each (or enter NONE if appropriate) *

Do you drink alcohol? *
NoYes

If Yes, how often?

Have you ever used illegal drugs or unprescribed drugs? *
NoYes

If Yes, which drugs and how often?

Have you ever been arrested? *
NoYes

If Yes, provide details.