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Surrogate Application

Trust our family to help grow yours!

Surrogate Application

Want to be a surrogate? We would like to thank you for your interest in becoming a Gestational Carrier through our agency, Surrogate Alternatives. The idea of carrying a child for an infertile couple is truly commendable. When a couple can't have a child of their own, it is heartbreaking. Thanks to people like you, who are interested in sharing such a special gift, couples are able to make their dream of becoming a parent - a REALITY!!

Apply to be a gestational carrier by filling out our quick application and our Surrogate Program Director will contact you shortly to discuss the next steps. If you have any questions regarding our surrogate mother application, please do not hesitate to reach out to our dedicated staff. They can help you with your surrogacy application and can address any concerns you may have.

Through the month of February SAI is currently offering a $1,000 sign-on bonus and a $500 referral bonus to anyone who refers a surrogate! Start your application for surrogate mother with SAI today!

Thank you again for your kindness and generosity!

"*" indicates required fields

Your Personal Details

Name*
Email*
Address*
MM slash DD slash YYYY
Explicit Consent (Recommended for Best Compliance):*
Emergency Contact Name
What is your ethnic background?

Do you practice a religion?
What religions do you practice?
What is your marital status

What are the names and ages of the people living with you?
Name
Age
 
Do you have reliable transportation?*
Are you willing and able to travel 2-5 times if you are reimbursed for all travel?*
Do you agree to take any and all medications and/or injections for up to 4 months?*
Do you and your partner agree to complete all required testing, including STD testing?*
Do you and your partner agree to abstain from sexual intercourse / stimulation as instructed by the physician?*
Do you agree to obtain written physician approval to travel within the U.S. after 24 weeks of pregnancy and to inform the agency?*
What is your height?
Do you drink alcoholic beverages while pregnant?*
Do you drink caffeine while pregnant?*
Are you willing to eat organic food if requested by Future Parents and Reimbursed for the costs?*
Have you had a history of psychological issues?*
Have you ever been institutionalized?*

Your Surrogacy Journey

Multiples are very common with surrogacy. It is the industry standard to place two embryos into the uterus to increase the chances of a positive pregnancy. Knowing this information, please answer the following:
Are you willing to carry a single child?*
Are you willing to carry twins?*
Are you willing to carry triplets?*

Termination and Fetal reduction can sometimes be physician recommended to ensure the safety and health of a surrogate and the baby. Physicians will not perform a termination or fetal reduction for the sex of a baby, however the physician may recommend due to a genetic abnormality.

Are you willing to allow Future Parents the choice to terminate/reduce based on personal choice?*
Are you willing to terminate/reduce if medically necessary?*
Are you willing to reduce Triplets to Twins, if medically recommended?*
Are you willing to reduce Triplets to a Singleton, if medically recommended?*
Are you willing to reduce Twins to a Singleton, if medically recommended?*
Amniocentesis is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections, and also for sex determination, in which a small amount of amniotic fluid ,which contains fetal tissues, is sampled from the amniotic sac surrounding a developing fetus, and then the fetal DNA is examined for genetic abnormalities.
Are you willing to undergo an Amniocentesis, if medically recommended?*
Are you willing to undergo an Amniocentesis, if requested by Future Parents?*

Surrogate Alternatives, Inc (SAI) helps families from all over the world. If the Intended Parents are International, you will NOT be required to travel out of the U.S. Surrogates MUST deliver in a Surrogacy-friendly U.S. state. The Surrogates OB/Delivery Care will occur at a local clinic near the Surrogate’s residence.

Which of the following types of Intended Parents would you be willing to be matched with?

Pregnancy History

List*
Name
Gender (male/female)
Current Age
Month & Year Born
Weight (at birth)
Twin Pregnancy (Yes/No)
Delivery (Vaginal / C-Section)
Type (Biological / Surrogacy)
 
Did you have any complications during these pregnancies?
Which of the following conditions did you have during your pregnancy?
Do you have a history of miscarriage(s)?
Have you had an elective termination/abortion?
Are you currently using birth control?
Have you ever been diagnosed with a sexually transmitted disease (STD)?
Have you ever had an HIV screening completed?
Have you had any history of abnormal PAP Smears?
If so, have you had normal PAP smears since?
Have you completed the Hepatitis B immunization?
Have you been vaccinated against COVID-19?
If answered NO would you be willing?
Are you currently on any prescription medication?
Have you had any surgeries other than a C-section delivery?

About You

Do you speak another language?
Are you currently employed?
Are you employed full time or part time?*
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    How did you hear about us?
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    Testimonials

    • We could not have asked for things to go more smoothly that they did with Surrogate Alternatives… not only their kindness, but for their vast knowledge of the entire process. I thank them every day in my heart for doing what they do, for without them, I would have never known what to do first Read more.
      Ginger & Bill, parents to Baby Lorence
    • I am currently working with SAI and they have been there for me every single step of the way from questions to procedures they are always there. And if I ever forget to ask a question I shoot over a simple email and within an hour I almost always have a response! They are always Read more.
      Nicole L.
    • SAI changed our lives for the best! Our twin boys are a miracle in our lives. Game changers! The staff is amazing and the experience has been supportive and full of love. Choosing a California surrogacy agency is as easy as S A I!! Read more.
      Donald Collins

    SAI West

    Surrogate Alternatives, Inc.
    882 Starboard St.
    Chula Vista, CA. 91914
    619-397-0757
    [email protected]

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