I Want to be a Surrogate — Screening Form

Thank you for your interest in being a surrogate mother with Creative Conception, Inc.! In order to be considered for our Surrogate program, you must meet the following minimum requirements and check the checkbox:

By checking this checkbox, I confirm that I, the surrogate applicant, meet the following requirements:
  • I am a United States citizen currently residing in the United States
  • I have at least one child born that I am mothering
  • I am a NON-Smoker
  • I am between 21-41 years old
  • I have a BMI under 32 for my height and weight (please refer to a BMI chart)