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SURROGACY SERVICES QUESTIONNAIRE 
Thank you for filling out this questionnaire to help us personalize your surrogacy plan and services!

Intended Parent 1

Gender

Intended Parent 2 (if applicable)

Gender

Additional Contact Information ( please choose 1 primary phone number and address)

Starting Surrogacy 

Surrogacy Services Interested In: (Multicheck boxes) Required
Has your doctor recommended surrogacy?
Do you have frozen eggs or sperm?
Do you have frozen embryos?
Have you done IVF before?
If embryos were created, have they been genetically tested?
(For US residents only) How open are you to using a gestational carrier outside of your state?

Your Story 

Surrogacy Support

How would you rank your financial readiness for a surrogacy journey?

No clue!

I'm/we're definitely financially ready. 

Are you interested in receiving financial counseling services for your surrogacy journey?

Intended Parent 1

How would you rank your overall emotional/mental wellness?

What is self-care?

It's my priority!

Are you interested in receiving coaching/therapy services during your surrogacy journey?

Intended Parent 2 (if applicable)

How would you rank your overall emotional/mental wellness?

What is self-care?

It's my priority!

Are you interested in receiving coaching/therapy services during your surrogacy journey?

Before you click submit, have you provided as much detail as possible?

Thanks for submitting!Congratulations on taking this step. We are here to guide you, ease the stress and provide detailed information for your journey. A GFC Consultant will contact you within 3 business days to set up time to review your personalized plan. If you have any questions in the meantime, please do not hesitate to reach out to info@globalfertilityconnections.com.

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