Intended Parent Profile Information

Please fill out the following to give us information to build your online profile.

Intended Parent's (1) First Name:(Required)

Intended Parent's (2) Spouse/Partner’s First Name (if applicable):

Your Location:(Required)

This field is hidden when viewing the form

Email Address:(Required)

Profile Information:

Please fill out the following information as you would like it posted on your profile.

Name of IVF Clinic:(Required)

Occupation(s): For example... Website Developer (Mark) / Nurse (Susan)(Required)

Embryo Status: For example... "3 frozen embryos", "Fresh IVF Cycle", "8 Frozen PGS Embryos", "IVF Cycle in Process..."(Required)

Children: (number of children you have)(Required)

Short intro blurb for profile ie "We are excited to start this next chapter in our life..."(Required)

Information about you (and how you and your partner met if applicable):(Required)

Describe your upbringing and family:

Information about your infertility/struggles (or reasons) to start your family (include any children, how many embryos you have):

Describe your home/neighbourhood and where you plan to raise your child.

Please fill out any other details about yourself such as occupations, pets, hobbies, what you like to do for fun etc.

How you will support your surrogate during pre-pregnancy, pregnancy and post partum (include covering all her costs/expenses):

What type of relationship/contact do you hope to have with your surrogate during and after pregnancy? (Surrogates always desire to have some type of ongoing contact with you if possible).

Final message to potential surrogate (such as "thank you for reading our story and considering being our surrogate!")

Profile Images

Please provide Surrogacy in Canada Online with a main profile picture image and 5 to 10 addtional images for your profile. (If having trouble uploading, you can email pictures directly to sally@surrogacy.ca)

Main profile picture preference.

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 15 MB.

Images of yourself/partner/family. Please upload 5 to 10 images.

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 30 MB, Max. files: 10.

Please wait until you see the thank you page before closing this page as images may cause this form to take time to process.