Surrogate Questionnaire | Les Petits Surrogacy

What would your family do with an extra 💰$65,000 to $115,000💰?*

💵Pay off debt so fast your credit score sends a thank-you card

🏫Fund college, braces, camps or sports – whatever your kids need to succeed

💭Invest in your dreams: Get a degree 📚, travel, buy a house, retire, invest, start a new business

🌴Trade financial stress for family memories … and maybe matching vacation hoodies

🐣Just helping another family bring home their baby is reward enough, but building a nest egg would be nice too!

First things first — how many babies have you delivered?*

👣 I’m a proud mama of one

👣 Two

👣 Three or more

👣 None yet, but I’m curious about surrogacy

How old are you?*

😊19-25

🧑‍🦱26-32

🧔33-42

🧔43+

Are you a U.S. resident?*

✅U.S. citizen

✅U.S. permanent resident

✅Other citizenship status

How would you describe your pregnancies?*

⛵ Smooth sailing

🌈 Mostly easy with minor bumps

💪 Challenging, but manageable

🩺 I experienced complications

🕰️Haven’t had a baby yet, so time will tell!

Have you ever been a surrogate before?*

🌟 Yes — and I loved it

🌟 Yes — but I have questions before doing it again

🌟 No, this would be my first surrogacy journey

How supportive is your household of you exploring surrogacy?*

❤️❤️❤️ Fully supportive

❤️❤️ Mostly supportive

❤️ Still discussing it

🩶 Prefer not to say

What matters most to you in your surrogacy journey?*

(Be honest — there’s no wrong answer here 💛)

✨ Building a real, lasting connection with the intended parents

✨ Feeling supported, heard and taken care of every step of the way

✨ A smooth, well-guided journey with clear communication (less stress, more peace)

✨ Making a life-changing difference for a family who needs me

✨ A little bit of everything – because this journey is kind of a big deal

Are you ready to get going?

✅Yes! Send me the application.

📱Not yet. I have some questions. Please contact me:

🤔No, I’m still thinking about it.

👎No. I don’t think this is for me.

What is your first name?*

How do you want us to reach you? (email/phone)*

Email*

Phone*

No problem, we understand! We are here if you need us. Would like for us to follow up with you in 72 hours to see if you have any questions?*

Yes

No, I will contact you when I’m ready.

What is your first name?*

How do you want us to reach you? (email/phone)*

Email*

Phone*

No problem. We understand. You have our contact information if we can answer any questions for you. Here is a story about a successful surrogacy journey if you want to learn more.

Surrogacy Application - Click Here