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Surrogate Application

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Application Process

Become a surrogate mother and help families fulfill their dreams of parenthood

Step 1: Submit the Surrogate Mother Pre-screening Form

The first step to get you started is submitting the Surrogate Mother Pre-screening Form. In this form, you will fill out some information about yourself. We will review the form you submitted and check if you meet the surrogacy requirements. After submitting, you can create an account through the Patriot Conceptions Surrogate Application Portal to continue your application.

Step 2: Continue your application in the Patriot Conceptions Application Portal

In the Portal, you will continue your application and provide all the information that is relevant to becoming a surrogate.This includes your birth records, medical information, your preferences regarding your surrogacy journey, and other information that will help us, and more importantly, the intended parents, get to know you better.

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Step 3: Submit the Background Check Authorization

We run a background check on all the surrogate mothers to make sure that our surrogate mothers maintain a healthy and safe lifestyle. The background check result will remain confidential and will be used for surrogacy purposes only.

Step 4: Submit the Medical Record Authorization

HIPAA Compliant Patient Information Authorization, aka Medical Record Authorization, is required by regulation to proceed with the surrogacy process. This form authorizes Patriot Conceptions to check if the surrogate mother is ready for surrogacy from a medical perspective.

Surrogate Pre-screening Form

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