I understand that as a surrogate, I would be required to take self-administered
injections for approximately twelve to fourteen weeks. |
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I am a resident of California. |
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I am a healthy woman between the ages of 21-38. |
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As a surrogate, I understand the primary requirements to be considered as an applicant include I must be a non-smoker, non-drug user and have given birth to at least one child (preferably within the last five years) without any major complications. |
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I am neither significantly overweight nor underweight for my height (BMI must not exceed 30. If unsure, click here to check your BMI) |
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I understand that as a surrogate, I will be required to submit to medical
and psychological screening and attend regular clinic appointments throughout the duration of the IVF (In Vitro Fertilization)
cycle. |
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I understand that in a gestational surrogacy arrangement my eggs are not
used and I am not the biological mother of any child conceived through IVF. |
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I understand the decision of becoming a gestational surrogate
and process of surrogacy is an extremely important matter which requires me to be fully dedicated throughout the
entire process and that because the Intended Parents are entrusting me to commit myself to this process, I must comply
with the instructions given to me in order to ensure and increase the possibility of a successful pregnancy for the
Intended Parents. |
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I agree to answer all the questions on the application truthfully
and factually to the best of my ability. |
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