Gestational Carrier Matching Questionnaire

Thank you for visiting our Gestational Carrier (Surrogate) Matching Questionnaire page. We’re so glad you’re here.
This questionnaire is a crucial step in helping us get to know you and ensuring we make the most thoughtful, meaningful match between you and intended parents. Your responses will help us understand not just your background and lifestyle, but also your motivations, personality, and preferences — all of which matter deeply in this process.

Please take your time and answer each question honestly, thoroughly, and with heart. Many of your responses will be used to create your surrogate profile, which may be shared with intended parents considering you for their journey. This is your opportunity to introduce yourself — to help someone out there see the amazing person who might help build their family.

If you have any questions as you go, please don’t hesitate to reach out. We’re here for you every step of the way.
Thank you again for your time, your openness, and most of all — your willingness to give such an extraordinary gift.

Name(Required)

First Last

Email(Required)

Have you previously been a surrogate? If so, please share your experience.

Tell us what interests you in becoming a gestational carrier (surrogate)!

Please list any religious affiliation.

Do you have any pets? Is so, what kind and how many?(Required)

What are your dietary habits?(Required)

Would you be willing to change your dietary habits at the request of the Intended Parents?(Required)

Additional stipends may be awarded to help facilitate changes.

Do you plan to consume caffeine during pregnancy? Is so, how much and how often?(Required)

Would you be willing to stop caffeine intake if requested by the intended parents?(Required)

yes

Do you have a workout routine? If so, what kind and how often?(Required)

What is your profession?(Required)

If your full time job is raising your kids, please let us know all about it!

What do you love most about your job?(Required)

Do you have a list of favorites?(Required)

books, tv shows, movies, Broadway shows?

If you could travel anywhere, where would it be?(Required)

What were your favorite school subjects? If you went to college, what was your major? Are you currently studying anything?(Required)

What is your fondest childhood memory?(Required)

Describe your personality and character(Required)

Why do you want to help another family through surrogacy?(Required)

What are you most nervous about during this journey? Do you foresee any possible emotional reactions or difficulties you might have?(Required)

Please describe your support system in detail. Who would provide emotional support during the entire process?(Required)

How does your closest support person feel about your interest in surrogacy?(Required)

The following questions relate to your partner/spouse. If you are not currently in a relationship, please skip the next four questions.

How did you meet your spouse/partner?

Does your spouse/partner have any reservations about your becoming a gestational carrier?

What do you and your spouse/partner do together for fun?

Aside from childbirth, what is a special experience you’ve shared with your spouse/partner?

What type of relationship are you expecting or hoping to have with your Intended Parent(s).(Required)

Please be as specific or as general as you’d like.

Would you expect or wish for any contact or information about the child or family after birth? Please elaborate as much as possible.(Required)

Are you willing to undergo any non-invasive prenatal screening requested by the intended parent?(Required)

yes

Are you willing to undergo invasive screening (such as amniocentesis) if requested by the intended parent? Or only if recommended by the doctor if other testing shows a potential issue?:(Required)

Additional compensation would apply.

The following questions relate to selective reduction/termination/abortion. Please answer each question as thoroughly as possible.

If it is determined that there is a physiological malformation of the child which would not affect your health, would you allow the intended parent to make the decision to terminate or continue the pregnancy?(Required)

Are there specific conditions under which you would not abort a pregnancy? If so, please elaborate.(Required)

Would you, as the surrogate carrying the fetuses, require selective reduction in the case of more than twins?

As long as a physician determines your health is not at risk, are you willing to let the intended parent(s) have the choice whether to selectively reduce in the case of more than twins?(Required)

Are there any circumstances under which you would not allow a selective reduction? Please explain.(Required)

Would you be willing to transfer 2 embryos for the hope of a twin pregnancy?:(Required)

yes

What are your general thoughts about carrying a twin pregnancy?:(Required)

Considering both double embryo transfers, and the possibility of a single embryo splitting.

If you are currently working, would you require additional compensation for lost wages? If so, what is your current hourly, monthly or yearly wage?:(Required)

What is your ideal compensation rate/range?:(Required)

Would you be willing to carry for a couple that already has children?(Required)

yes

Would you be willing to carry for a Single Male?(Required)

yes

Would you be willing to carry for a Single Female?(Required)

yes

Would you be willing to carry for a Same-sex Male Couple?(Required)

yes

Would you be willing to carry for a Same-sex Female Couple?(Required)

yes

Would you be willing to carry for a person over the age of 50?(Required)

yes

Do you have any other matching preferences that are extremely important to you?(Required)

Or any other general thoughts that may be of note.