PreScreening Quiz

Become a Surrogate - Pregnant Lady
Surrogate Prescreening Application

New Beginnings Surrogacy
Body Mass Index Calculator

Please input your information to calculate your BMI.
Have you given birth before?
Have you used any form of tobacco in the 6 months?
Have you used antidepressants in the last 6 months?
Have you had any history of illegal drug use of alcohol abuse?
Have you ever had a C-section?
Have you ever been diagnosed with:
Gestational Diabetes?
Any history of STDs?
Toxemia (Eclampsia)?
Pre-Eclampsia?
Pregnancy-induced Hypertension?
Have you been a surrogate mother before?
How many times have you given birth as a surrogate? (if applicable)
Are you currently receiving any government financial assistance (including food stamps, public housing, welfare, Medicaid)?
Have you or your husband/partner ever been convicted of a felony, including DUI?
If yes, please explain:
How did you hear about us?

Become a surrogate today.

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