Surrogate Application Form | Patriot Conceptions

Surrogate Application

Become a Surrogate: Apply Below

Are you ready to embark on a life-changing journey? Patriot Conceptions is seeking compassionate women to become surrogates. Take the first step towards helping create families by completing our surrogate mother application below.

Compassionate surrogate holding hands with intended parents
Supportive group of surrogates smiling together

Surrogate Qualifications

Before you apply, please ensure you meet these basic surrogate requirements:

  • Age 21-40
  • Have given birth to and are raising at least one child
  • BMI between 18-32
  • Non-smoker and drug-free
  • U.S. citizen or permanent resident
  • Financially stable (not on government assistance)

Why Become a Surrogate with Patriot Conceptions?

  • Generous compensation package (up to $100,000+)
  • Comprehensive medical and life insurance
  • Dedicated support throughout your journey
  • Opportunity to help create families

Application Process

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 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.

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.

FAQs

How long does the surrogate application process take?

The initial application review typically takes 1-2 weeks. The entire process from application to matching can take 2-6 months.

Can I be a surrogate if I've had a C-section?

Yes, having had a C-section doesn't automatically disqualify you. We'll review your medical history in detail.

Do I need to have my own health insurance to be a surrogate?

While having your own health insurance can be beneficial, it's not a requirement. We provide medical coverage for the surrogate pregnancy.

Surrogate Pre-screening Application Form

Ready to take the next step? Submit your surrogate application today and join our community of amazing women making dreams come true!