Alternative Conceptions

Parents through Surrogacy Registration

Items with an * are required to submit your registration

General Information

Parent First Name: *

Parent Last Name: *

Partner First Name: *

Partner Last Name: *

Address: *

City: *

State: *

Zip: *

Email: *

Best Contact Phone #: *

Ok to leave a message?: *

Second Phone #: *

Third Phone #: *

How did you hear about us?: *

(Please name the specific Search Engine if you found us on the internet.)

Treating Physician: *

Physical Characteristics

Parent

Hair Color: *

Eye Color: *

Skin Tone: *

Race/Ethnicity: *

Height: *

Weight: *

Special Interests/Talents: *

Partner

Hair Color: *

Eye Color: *

Skin Tone: *

Race/Ethnicity: *

Height: *

Weight: *

Special Interests/Talents: *

Desired Surrogate

Hair Color: *

Eye Color: *

Skin Tone: *

Race/Ethnicity: *

Height: *

Weight: *

Special Interests/Talents: *

Gestational or traditional surrogacy?: *

What kind of relationship do you want with the surrogate? What level of involvement do you want to have with your surrogate? Attend doctor's visits? Ultrasounds? Birth? Or minimal involvement?: *

What characteristics in your surrogate are important to you (i.e., location, ethnicity, lifestyle, etc.): *

Is there anything else you would like us to consider when we are making your match?:

Image CAPTCHA

What code is in the image?: *

Copy the characters (respecting upper/lower case) from the image.

Copyright 2000-2007 © Alternative Conceptions - All Rights Reserved.

Testimonials

"We just wanted to thank you so much for all your help and guidance through this exciting process. You have been with us from the very beginning and we have always felt that you have gone above and beyond for us. Again, we thank you so much for all you have done."
-- N&R - CA
"Thank you so much for introducing us to our surrogate who made all this possible. We are delighted with our twins!"
-- C&R - CA
"Our donor was a doll. Although we never met she was very responsible and gave us a lot of eggs. I am currently pregnant with one of her egg donations."
-- H&J - NY
"Thank you for your help and support in helping us find a donor.
We were blessed with 2 beautiful babies last June!"
-- The R. family - CA
"You have been most helpful in dealing with our situation.
We appreciate what you have done and please remember us in your prayers."
-- R&J - CA
"Our Donor was wonderful and very responsible.
We have several attempts at the process due to her dedication & commitment to the cycle."
-- F&J - CA
"What we all went through together will remain indelibly etched in my memory. Thank you so much!"
-- V&G - CA
"Your Case Manager made sure to check in with me every week. If I sent her an email, I had a response the same day, usually within the hour! If I needed her to send me paperwork, it was in the mail the very next day. I have really enjoyed donating for A.C. this year!"
-- A. - OR
"You have been so pleasant and helpful during this process.
We really appreciate your kindness and all of your informative phone calls that you have given us this past year."
-- W&M - IL

News

free hit counter script