Change your life... Become a Surrogate!
Let's find out if you will be an ALL STAR surrogate!
Image Source
Quiz Questions
1.
Have you ever been a surrogate before?
Image Source
A.
Yes
B.
No
2.
Are you between the ages of 22-38?
Image Source
A.
Yes
B.
No
3.
Have you had at least one healthy, full term pregnancy and delivery? (38 weeks+ singleton)
Image Source
A.
Yes
B.
No
4.
In any of my pregnancies, I have had the following complications...
Image Source
A.
Preeclampsia (High Blood Pressure)
B.
Gestational Diabetes that needed medication
C.
Baby born before 36 weeks
D.
Premature labor
E.
Postpartum hemorrhage
F.
Still birth
G.
Baby that weighed less than 6 lbs at birth
H.
Uterine rupture
I.
Some other complication
J.
None of the above
5.
In my pregnancies, I...
Image Source
A.
Used tobacco products (cigarettes, vape)
B.
Used any form of marijuana
C.
Drank alcohol
6.
Would you and your partner (if you have one) be able to pass a criminal background check?
Image Source
A.
Yes, nothing there.
B.
Misdemeanor arrest or arrests with dropped charges (ie, DUI, marijuana arrest, all more than 3 years ago)
C.
I have no arrests but my partner does.
D.
Felony convictions
7.
What is your citizenship status?
Image Source
A.
I am a U.S. Citizen
B.
I am a Permanent Resident
C.
I am on a work visa
D.
I am a citizen of another country and am on a temporary visa.
E.
I have a green card.
8.
Do you currently receive any of the following financial assistance?
Image Source
A.
Cash Aid/EBT/Food Stamps
B.
Section 8 housing
C.
Both
D.
None of the above
9.
Do you have a healthy BMI under 30?
Image Source
A.
I am 4'11" and under 145 lbs
B.
I am 5' and under 150 lbs
C.
I am 5'1" and under 158 lbs
D.
I am 5'2" and under 163 lbs
E.
I am 5'3" and under 168 lbs
F.
I am 5'4'' and under 173
G.
I am 5'5" and under 179
H.
I am 5'6" and under 183
I.
I am 5'7" and under 188
J.
I am 5'8" and under 195 lbs
K.
I am 5'9" and under 200 lbs
L.
I am 5'10" and under 206 lbs
M.
I am 5'11" and under 212 lbs
N.
I am 6' and under 218 lbs
O.
I am close to one of these (within 8 lbs) and am willing to work on my weight.
P.
I am not close to any of these.
10.
Why do you want to become a surrogate?
Image Source
A.
I want to help a person or couple become parents.
B.
I want to help my own family financially
C.
Neither
D.
Both
Quiz Outcomes
1.
Uh oh, looks like surrogacy isn't right for you a the current time.
Image Source
Unfortunately, it looks like there is something that would disqualify you from surrogacy. Click below to see what the requirements are.
2.
There may be a little hiccup. Reach out to see if you qualify.
Image Source
It isn't a "no", but it's not a "yes" yet! Reach out to Genevieve at genevieve@rootssurrogacy.com for more info.
3.
You would make an AMAZING Surrogate!
Image Source
Congratulations! You are well on your way to becoming an amazing surrogate. Click the link below to give us some more information and we will reach out to you with all the information and answers to all of your questions!
