Surrogate Application Checklist

Welcome to PrimeSurro

PrimeSurro appreciates you for expressing your interest in applying to become a surrogate mother. Our team members at PrimeSurro would like to take a moment to thank you for your kindness and compassion. Congratulations on filling out the Surrogate Intake Form, which is the first step of our surrogate application process. In order to fully complete the entire surrogate application, please fill out the form below and a PrimeSurro team member will contact you shortly. If you have any questions or concerns when you are completing the form, do not hesitate to contact your surrogate consultant for assistance. If you do not have an assigned surrogate consultant to help you, contact PrimeSurro at (833)-966-0990.


Personal Information

In order to create your personal profile during the reviewing process, we would like to ask for some more information, beautiful family photos, and expectations during your surrogacy journey.


  • At least 5 family photos with your children or spouse

  • Please provide a detailed description for each photo


Medical Information

Our medical records requesting process requires your birth history and medical insurance information. Under the signed Medical Record Release Consent Form, PrimeSurro is given authorization to request information regarding your medical records. After collecting all the pregnancy related medical documents, our medical records team will review the data during the prescreening. Our PrimeSurro medical records team will need to request the following documents, including, but not limited to, OB / GYN records, prenatal records, labor and delivery records, lab results, and pap smear results.

Checklist :​

  • Full birth history

  • Medical insurance information (ex. ID card, EOC)

  • Detailed OB/GYN office and delivery hospital information for all past deliveries 


Background Check authroization

PrimeSurro requires every surrogate to sign the Background Check Authorization form at the end of the application form. We do not share you information with any third parties, including intended parents.

Checklist :

  • Personal contact and emergency contact information

  • Social security number

  • Driver license number

Expedited Application Bonus

Surrogate mothers do not only bring life, but also hope and joy to the intended parents. Surrogates are given the chance to provide an incredible gift in a unique way that no one else can. PrimeSurro sincerely appreciates your personal decision, time, and energy involved in different stages of the surrogacy journey. After the approval process of your medical records and fulfillment of the following two requirements, PrimeSurro would like to offer you a $500 signing bonus as part of your compensation package.



  • Completion of the application checklist (Full Application, Background Check Authorization, and Authorization for Release of Medical Records) within 72 hours after the initial phone consultation.

  • Pass the medical records screening successfully

Address: 300 Spectrum Center Dr, Suite 1000

Irvine, California

Phone: (833) 966-0990


Monday through Friday : 8:00 a.m. to 5:00 p.m.

Saturday and Sunday : Appointment Only 



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Intended Parents

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