The Surrogacy Experience - Gestational Carrier Intake

Gestational Carrier Intake

Thank you for being so interested in becoming a Gestational Carrier and taking the first steps to help a future parent.

For many women, giving the gift of a child to another family can be a deeply rewarding experience. At The Surrogacy Experience (TSE), we understand that feeling because our agency was founded on the personal experience of an intended parent, and the owner is an experienced gestational carrier.

We are committed to providing you with the information and resources needed to understand if becoming a Gestational Carrier is right for you and your loved ones.

To begin, please fill out this brief questionnaire.

First Name*

Last Name*

Primary Email*

Primary Phone

Are you a citizen, legal resident, or legal immigrant of the United States?*

Thank you for your inquiry.

The Surrogacy Experience does not offer an international surrogacy program.

We are only equipped to work with women living in the United States and hold legal citizenship.

State of Residency*

Thank you for your inquiry.

However, we currently are not accepting applications from those residing in Louisiana, or Nebraska.

This is due to unfavorable Surrogacy Laws.

Date of Birth (mm/dd/year):

Due to legal, medical, and agency requirements, all carrier candidates should be between 21 - 40 years of age.

Have you given birth to a child and are raising / or have raised that child?*

It is a medical requirement that all potential gestational carriers must have given birth to at least one child of their own who they are/have raised and that the pregnancy and delivery were free of any complications.

Have you had more than 3 C-section deliveries?*

For the health of the gestational carrier and the success rate of embryo implantation, our medical professionals have maximum restriction on the number of previous C-section deliveries.

Did you experience any complications during any of your pregnancies or deliveries? (i.e. pre-term labor, gestational diabetes, bed rest, emergency C-section, etc.)*

Pregnancy Complications: List complication, for which pregnancy (if you had multiple), treatment, and any other information.*

Is your current BMI (Body Mass Index) greater than 32?*

For your health and to reduce the chances of pregnancy-related health issues, we require a BMI range to be between 19 – 32.

Click Link to determine BMI: BMI Calculator Tool

Do you or any member of your family receive government assistance?*

If yes; what type of assistance are you receiving, check all that apply:*

Cash Assistance

Public Housing

WIC/Food Stamps

Welfare

Section 8

Medicaid

As a surrogate mother your compensation could be considered "earned" income. We recommend that you speak with your healthcare agent to make sure that the income you receive will not impact your medical assistance.

Due to laws surrounding gestational surrogacy and reporting income when you receive government assistance, we are unable to accept applicants who are currently enrolled (or their household) in the following government programs: Section 8, Public Housing, Welfare, and Cash Assistance.

Have you used any nicotine products (including vaping, chewing tobaccos, etc.) within the last 10 months?*

We require all candidates to be nicotine-free for a minimum of 10 months.

Message to Agency (optional):

Congratulations on taking the first step to becoming a

Gestational Carrier

A team member will reach out to you within 48 business hours. Please check your spam/junk folder to avoid missing any critical updates.

If you want to request a consultation call, please email us at info@thesurrogacyexperience.com.

Thank you!