Quiz | Make Families

Quiz

Are you between the ages of 21 and 39?



Is your BMI under 33?



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Have you given birth before?



Do you live in one of these states? Arizona, Wyoming, Nebraska, Louisiana, Iowa, Mississippi, Tennessee, Indiana, Michigan, Virginia?



Are you a U.S. Citizen, and if not, do you have a valid green card or work permit?



Do you have a valid driver's license and reliable transportation?



Do you have car insurance?



Do you smoke or use tobacco?



Do you currently use recreational drugs?



Do you drink alcohol daily?



Would you be willing to stop consuming alcohol if you become pregnant?



Drug testing is part of the surrogate screening process. Are you willing to take a drug test?



Have you or your partner ever been convicted of a felony?



Are you currently receiving any type of government assistance such as welfare or food stamps? (State Health Insurance okay)



Were any of your singleton pregnancies delivered before 37 weeks?



Have you had more than 3 C-Sections?



Have you had more than 3 abortions?



Have you had 3 or more miscarriages?



Have you ever lost custody of a child?



Have you ever been diagnosed with Schizophrenia, Bipolar Disorder, Post Traumatic Stress Disorder, or severe Post-Partum Depression?



Have you ever taken anti-depressants, anti-psychotics, or anti-anxiety medications during pregnancy?



Do you suffer from frequent panic attacks?



If your application is approved, are you willing to have your full medical records released?



If your application is approved are you (and your spouse or partner, if applicable) willing to have a full background check conducted?







We may send you more information about surrogacy.

Your Results

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*Incorrect answers in red