Questionnaire for Surrogate Mothers
To become a surrogate mother

Requirements:

  • Age: 24 – 34
  • Physical health (absence of diseases, including previous hepatitis, skin and venereal diseases, hereditary and other serious diseases);
  • mental health (absence of nervous and mental disorders, including previous and hereditary);
  • absence of unsuccessful history of pregnancy and delivery;
  • availability of one or two own children;
  • absence of bad habits (smoking, alcohol, drug, substance abuse);
  • absence of problems with the law;
  • Ukrainian citizenship and residence in Ukraine.

For our manager to contact you, please fill in the contact form below.

After a conversation with our manager, you have to fill out a questionnaire with personal information.

Personal information
Name
Phone
Email
Address
Date of Birth
Family status
Growth (centimeters)
Weight (kilogram)
Natural hair color
Hair texture
Eyes
Blood group and Rh factor
Nationality
National appearance
Education
Profession
The desired amount of compensation
Have you ever had a criminal record?  Yes No
You are under the supervision of a physician?  Yes No
Operations that you move (dates, reasons, results)
Do you smoke? Yes No
Do you drink alcohol? Yes No
You have regular menstrual cycles? Yes No
The duration of the menstrual cycle days
Have you been a donor or a surrogate mother? Yes No
Number of pregnancies
Number of abortions
Amount of children
Problems and complications during pregnancy or childbirth Yes No
Did you have a cesarean section? Yes No
Whether you were registered by a psychiatrist? Yes No
Additional Information

Surrogacy Program Packages

We organize provision of highly qualified medical and legal assistance to you at all stages of surrogacy programs regardless of which program package you select.

Standard
Standard

The Standard Surrogacy Program Package offered by the babyforyou Agency includes all the necessary options aimed at achieving the main goal of our cooperation – to make you happy parents of your own healthy child.

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Premium
Premium

The babyforyou Agency’s program “Surrogacy Premium” includes all the options necessary to achieve your goal – to have your own baby. The contract is based on the “all inclusive” system.

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VIP
VIP

The VIP program belongs to the “all inclusive” tariff series. It is developed and calculated on the basis of any wishes you may have.

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