Apply as a Surrogate

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We just need the basics to get started. This takes about 10–15 minutes total, and you can save your progress at any time.

Full name *

Please enter your full name.

Email address *

Please enter a valid email.

Phone number *

Please enter your phone number.

Date of birth *

Please enter your date of birth.

Age requirement heads-up

State of residence *

Please select your state.

City *

Please enter your city.

Agencies use this to ensure a healthy pregnancy for you and the baby. All information is kept strictly confidential.

Height & Weight

Feet *

Inches *

Weight (lbs) *

BMI (auto)

—

Please enter your height and weight.

BMI heads-up

Your BMI is above 32. Most agencies require a BMI under 32–35 for surrogacy. Some agencies have flexibility — you can still apply and we'll match you with the most compatible options.

Do you smoke? *

🚭 No, never

✅ Quit smoking

🚬 Currently smoke

Please select an option.

Smoking policy

Active smoking is a disqualifying factor for most surrogacy agencies. You can still submit your application — we'll note this in your profile and match you with agencies that may have flexibility, though options will be limited.

Do you use recreational drugs or marijuana? *

Marijuana occasionally

Other / multiple

Please select an option.

Current medications (prescription or OTC — leave blank if none)

Any chronic health conditions? (check all that apply)

None Diabetes Hypertension Autoimmune condition Thyroid disorder Other

Mental health history (check all that apply)

None Depression Anxiety PTSD Bipolar disorder Other

Are you currently in treatment or on medication for this?

Yes

No / resolved

Your pregnancy history helps agencies understand your experience and eligibility. Most agencies require at least one prior live birth.

Total number of pregnancies *

Please select.

Number of live births *

Please select.

Prior birth required

Nearly all surrogacy agencies require at least one prior successful live birth. You may still submit your application, but your options will be very limited until you have delivered a child of your own.

Any pregnancy complications? (check all that apply)

None Gestational diabetes Preeclampsia Preterm birth C-section Other

Age of your youngest child (leave blank if no children)

years old

Are you currently breastfeeding? *

Yes, currently

N/A (no children)

Please select an option.

Any miscarriages or terminations? (optional)

Miscarriages:

Terminations:

Tell us about your surrogacy experience and preferences. There are no wrong answers here.

Have you been a surrogate before? *

🌱 First-time surrogate

⭐ Experienced surrogate

Please select an option.

How many journeys?

Would you use your previous agency again?

Yes

Maybe

Previous agency name(s)

What motivates you to become a surrogate? *

Please share your motivation.

Please indicate your preferences on these important topics: *

Willing to carry multiples (twins)?

Yes

Open to discussing

Please select.

Willing to undergo selective reduction if medically recommended?

Selective reduction reduces the number of embryos in a multi-fetal pregnancy for medical reasons.

Yes

Depends / discuss

Please select.

Willing to terminate for serious medical reasons?

e.g. fatal fetal abnormality or life-threatening risk to the surrogate.

Yes

Depends / discuss

Please select.

Any preferences on intended parents? (check all you're open to)

No preference Heterosexual couple Same-sex couple Single parent International IPs US only

Agencies want to ensure you have the stability and support needed for a healthy surrogacy journey.

Relationship / marital status *

Single

In a relationship

Married

Divorced / separated

Please select your status.

Does your partner or family support your decision to become a surrogate? *

Fully supportive

Mostly supportive

Mixed / unsure

My decision, solo

Please select.

Employment status *

Please select.

Annual household income *

Please select.

Do you currently receive government assistance? *

Yes (WIC, SNAP, Medicaid, etc.)

Please select.

Government assistance consideration

Most agencies require that surrogates are financially stable and not reliant on government assistance. Surrogate compensation cannot be the primary source of household income. You can still apply — we'll be transparent about this in your profile.

Do you have reliable transportation? *

Yes

Limited

Please select.

Do you have a support system during pregnancy? *

Yes

Some

Please select.

Criminal background — any felonies or misdemeanors? *

No criminal record

Minor misdemeanor

Felony

Please select.

Insurance and legal residency are key factors agencies evaluate. Having good insurance can significantly increase your compensation.

Current health insurance provider (or "none")

Insurance type *

Please select insurance type.

Are you a US citizen or permanent resident? *

Yes, US citizen

Permanent resident (green card)

Neither

Please select.

Are you willing to travel for medical appointments? *

Yes

Limited travel only

No / local only

Please select.

How far are you willing to travel for appointments?

Local (< 30 mi)

Regional (up to 100 mi)

Anywhere in my state

Anywhere nationally

Help us match you with agencies that fit your compensation expectations and preferences.

Desired base compensation range

$40,000

$55,000

base compensation

$80,000

First-time range Experienced / high-demand states

* This is your preferred base. Total compensation includes allowances for medical, maternity clothing, lost wages, and more — typically adding $10–$25K.

💰 Estimated total compensation for you

$65,000 – $80,000

Based on your state and experience level. Final offer depends on agency and intended parents.

What matters most to you? (pick your top 2)

💵 Compensation

⭐ Agency reputation

❤️ IP match quality

📍 Location / proximity

🤝 Support quality

⚡ Speed to match

Which agencies are you interested in? (select all that interest you, or let us match you)

🎯 Match me with the best fit Circle Surrogacy Surrogate First ConceiveAbilities Creative Family Connections Growing Generations Shady Grove Fertility Partners West Coast Surrogacy Family Creations Nevada Surrogacy

Anything else you'd like agencies to know?

Review your answers before submitting. Once submitted, our team will review your application and partner agencies will be able to reach out.

⚠️ Items that may affect your eligibility

These items will be noted in your profile. You can still submit — we'll match you with the most compatible agencies.

I understand that SurroScore will share my application with partner agencies who may contact me about surrogacy opportunities.

You must agree to continue.

I confirm that all information provided in this application is truthful and accurate to the best of my knowledge.

You must confirm accuracy.

Your data is encrypted and handled with HIPAA-level care.

Application Received! 🎉

Thank you for applying. Your application has been submitted to SurroScore. Our team will review it within 1–2 business days, and matched agencies will reach out to you directly.

What happens next:

1. SurroScore reviews your profile (1–2 days)
2. Matched agencies review and reach out
3. You'll receive agency offers to compare
4. You choose the right fit — no pressure

Browse Agencies While You Wait →