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- Surrogates: See if You Qualify!
- Intended Parents: Connect With Us

Home
Surrogates
Intended Parents
About Us
Blog
Get Started
- Surrogates: See if You Qualify!
- Intended Parents: Connect With Us

Intended Family Surrogacy Contact Form - Northwest Surrogacy Center, LLC

First Name* Last name Email Phone number* ✓ Valid
I have a partner

About your partner

First name Last name Email

Additional information

State* Country IVF clinic Would you be using the assistance of an egg donor? Reasons for considering surrogacy How did you hear about us?

Become a Surrogate

Become a Surrogate

Become a Parent

Become a Parent

San Francisco Office
1801 Bush St. Unit 220
San Francisco, CA 94109

Seattle Office
2101 4th Ave, Suite 1270
Seattle, WA 98121

Portland Office
2722 NE 33rd Ave

Portland, OR 97212

[email protected] | 503-233-2818

Northwest Surrogacy Center, LLC © 2025

First Name

Please enter your First Name

Last Name

Please enter your Last Name

Phone

Format: (123) 123-1234

Street Address

Please enter your Street Address

City

Please enter your City

State

Please choose your State

Zip Code

Please enter a 5-digit zip code

E-mail Address

Please enter a valid e-mail address

Birthdate

Please enter a valid birthdate (mm/dd/yyyy)

Height (feet)

Please select a valid height in feet (numbers only)

Height (Inches)

Please select a valid height in inches (numbers only)

Weight (lbs)

Please enter a valid weight (numbers only)

Do you have Native American heritage?

Please indicate whether you have Native American heritage

Number of pregnancies resulting in live birth(s)

Please fill out your number of pregnancies resulting in live birth(s)

Have you had a full-term pregnancy within the last 10 years?

Please indicate whether you have had a full-term pregnancy in the last 10 years.

Have you ever taken medications for depression or anxiety?

Please indicate your history with depression or anxiety

Do you smoke?

Please fill out your smoking history

Number of cesarean sections

Please indicate a number of c-sections

Number of miscarriages

Please indicate a number of miscarriages

Are you vaccinated for Covid-19?

Please indicate whether you been vaccinated for Covid-19

Although extremely unlikely, if a serious medical problem with the baby is discovered, most intended parents would like the option to consider termination of the pregnancy. This could be a range of medical reasons that prevent an acceptable quality of life, including chromosomal anomalies like Down Syndrome. Would you be comfortable with intended parents making the decision to terminate based on their personal beliefs and the advice of their doctors?

Please select your willingness to terminate for medical conditions

How did you hear about us?

Please indicate how you heard about us

If you were referred by a friend or family member, what is that person's name?

Thank you for your interest

Currently you do not qualify to become a surrogate with NWSC for the following reason(s):

Currently we only accept applicants who live in the following states:
- Oregon
- Washington
- California
- Connecticut
- Colorado
- Delaware
- Illinois
- Kansas
- Minnesota
- New Mexico
- Maine
- Massachusetts
- Maryland
- New Hampshire
- Nevada
- Pennsylvania
- Rhode Island
- Washington DC
- Vermont
If you move to or are planning to move into one of these states, we would love to talk to you!
The fertility clinics that we work with require a BMI under 35 to protect the surrogate and the baby. Your BMI is . While there are exceptions, women with a BMI of 35 or above are more likely to have complications during their pregnancies. Click here to learn more.
Clinics require that you have had at least one, and no more than 5, healthy pregnancies to reduce risks for the surrogate and baby during pregnancy.
Currently IVF clinics are requiring the Covid-19 vaccination as well as a number of other vaccinations for all surrogates.
Clinics require that you have had at least one full-term pregnancy in the last 10 years.

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