IP Profile Form - Single | Abundant Beginnings Co.

First Name:

Last Name:

City, State/Country where you reside:

E-mail:

Address:

Best number for us to reach you:

What fertility procedures have you tried?

Do you have frozen embryos? If yes, how many embryos do you have frozen and are they genetically tested?

Are you using an Egg Donor to help you create the embryos?

Are you using a Sperm Donor?

Is your intention to transfer one embryo or two?

When do you anticipate having the embryo transfer (month, year)?

Do you have other children?

What lead to your decision to pursue surrogacy in helping you have a child?

What is the name or your clinic or Reproductive Endocrinologist?

Would you prefer to work with a single surrogate, married surrogate, or no preference?

Do you have a preference on where your surrogate resides? All of our surrogates live in surrogacy friendly states.

Are you comfortable with a first time surrogate, or do you prefer a repeat surrogate? How flexible are you on this?

Do you plan to attend the Obstetrical appointments with your surrogate?

If it is determined that your Child has physical or genetic abnormalities (including Downs Syndrome), would you plan to terminate the pregnancy?

If the IVF process results in a multiples pregnancy, will you plan to selectively reduce if the doctor recommends this is the healthiest option for the surrogate and the baby(ies)?

Would you be willing to work with a surrogate who will not submit to a selective reduction?

What kind of relationship do you want with the surrogate during the pregnancy?

Do you want to be in the delivery room when your child is born?

What will you tell your child about his or her birth process?

Date of birth:

Sun Mon Tue Wed Thu Fri Sat

Birthplace:

Ethnic background:

Language(s) you speak:

Are you a US citizen?

What is your favorite type of music?

What is your favorite movie?

What are your favorite foods?

Do you have any pets? If yes, what kinds?

Do you have any hobbies?

How would you describe yourself and your personality?

What else would you like to tell the prospective surrogate about yourself? (Surrogates really enjoy learning about who you are and your interests, etc. It helps them feel a connection and to make a decision as to whether you feel like a good match for each other.)