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Intended Parents Quick Application
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Spouse/Partners Name
*
First
Last
What are you seeking help with (check all that apply)
*
Surrogate/Carrier
Egg Donation
Embryo Donation
Legal Assistance with Family Formation
How quickly are you looking to start your family journey
*
ASAP
1-3 months
3-6 months
6-12 months
Do you already have children
*
Yes
No
Have you worked with a surrogate, egg donor, or embryo donor previously
*
Yes
No
If Yes, please explain
*
Are you working with a fertility clinic
*
Yes
No
If Yes, which clinic
*
Have you ever been diagnosed or treated for any emotional disorder
*
Yes
No
Do you have any criminal arrests
*
Yes
No
How did you hear about A Family Tree Surrogacy, LLC
*
Google
Bing
Friend/Family
Facebook
Twitter
Surrogacy Organization
Fertility Clinic
Other social media
Other
By selecting "Agree", you are stating that you will and you have answered all questions to the best of your ability, without purposeful omission or deception.
*
Agree
By selecting “Agree”, you understand the following: Some of the questions in this application are very personal. No answers will be shared with anyone outside of A Family Tree Surrogacy, LLC without your permission. Certain questions and answers are not shared with recipients and are only used for our internal purposes.
*
Agree
How did you hear about A Family Tree Surrogacy, LLC
*
Internet Search
Facebook/Social Media
Print Advertisement
Men Having Babies
Referal
Infertility Support Group
Questions/Comments
*
Submit Application
Home
Surrogates
Compensation
Steps to Becoming a Surrogate
Application
Surrogate Mother Referral Bonus
Intended Parents
Find A Surrogate
LGBTQ+ Surrogacy
Costs and Financing
Surrogate Mother Profiles
Intended Parent Quick Application
About
Contact
Blog
Fertility Clinics
Egg / Embyro Donation
>
Egg Donor Application
News & Events
