Apply to Be a Surrogate

Apply to Be a Surrogate With Donor Nexus

At Donor Nexus, we offer generous packages with competitive compensations for first-time and repeat surrogates. We have a waiting list of hopeful intended parents looking to get started on their journey right away! We are a compassionate and supportive team that will help you and your family through the entire process from matching, to screening, to pregnancy and postpartum. Fill out our preliminary surrogate application below to get started!

We are currently only taking applicants who reside in surrogacy-friendly states.

Surrogate Preliminary Application

Please provide the following information:

Date of Birth:

We are currently only taking applicants who reside in surrogacy friendly states:

What is the highest level of education you've acheived?

Were you born in the US or Canada?

What is your marital status?

Will you have a partner or spouse on this journey with you?

Partner's First and Last Name (if applicable)

Partner's Date of Birth (if applicable)

What is your partner’s/spouse’s occupation?

Please answer the following:

Have you been a surrogate before?
Have you ever given birth before?
Have you delivered 6 or more pregnancies?
Have you had 3 or more c-sections?
Have you or your partner ever been convicted of a felony?
Do you or your partner currently have any outstanding legal obligations (bankruptcy, divorce proceedings, lawsuits, misdemeanor, and/or criminal offenses)?
Do you and/or your partner have any past, current, or ongoing open cases with Child Protective Services?
Have you received Cash Aid, Housing Aid, or Food Stamps (SNAP) within the last 3 months?
Have you had gastric surgery for the purpose of weight reduction?
Are you currently prescribed any psychological medications? (e.g. anti-depressants, anti-anxiety medications, ADD medications)?
Have you ever been diagnosed with Diabetes (not including gestational diabetes during pregnancy)?
Have you ever been diagnosed with a Pregnancy-Induced Hypertension?
Have you ever been diagnosed with Pre-Eclampsia?
Have you ever been diagnosed with ANY of the following conditions during pregnancy: Cholestasis, Toxemia, Incompetent Cervix, Placental Abruption, or Placenta Accreta?
Have you ever placed a child up for adoption?
Are you a US citizen?
Do you have a valid driver’s license?
Do you currently have health insurance?
Are you vaccinated against COVID-19?
Have you applied as a surrogate with other surrogate agencies?

Have you used any tobacco or nicotine containing products within the last year?

Why do you want to be a surrogate?

How did you hear about us?

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Apply to Be a Surrogate With Donor Nexus

Surrogate Preliminary Application

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