3 Sisters Surrogacy
THANK YOU FOR YOUR INTEREST IN 3 SISTERS SURROGACY. With our new higher compensation and support structure, we are here for YOU, every step of the way. Please fill out the Initial Application to get the process started!
 

1. Carefully review the following list of medical problems (CONGENITAL ABNORMALITIES/BIRTH DEFECTS) and identify which ones you or one of your genetic relatives have or had. Please consider each condition carefully for each family member. If you and none of your family members have a history of the specific medical condition, please check "None".
 
Birth Defects None Self Children Mother Father Sibling Grandparents Aunt/Uncle Cousin
Cleft Lip / Palate: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Congenital Hip Problems: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Club Feet: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Heart Defect: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Hearing Problems: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Spina Bifida - Neural Tube (open spine): Yes Yes Yes Yes Yes Yes Yes Yes Yes
Microcephaly: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Holoprosencehpaly - a single-lobed brain structure and severe skull and facial defects: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Other: Yes Yes Yes Yes Yes Yes Yes Yes Yes
For every relative, please indicate your relation to them (include maternal or paternal), the age of onset of the disease state, and any other pertinent information of which you are aware.
2. Carefully review the following list of medical problems (URINARY) and identify which ones you or one of your genetic relatives have or had. Please consider each condition carefully for each family member. If you and none of your family members have a history of the specific medical condition, please check "None".
 
Urinary None Self Children Mother Father Sibling Grandparents Aunt/Uncle Cousin
Kidney Problems: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Polycystic Kidney Disease: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Other disease/defect of urinary tract (urethra, bladder, ureter): Yes Yes Yes Yes Yes Yes Yes Yes Yes
For every relative, please indicate your relation to them (include maternal or paternal), the age of onset of the disease state, and any other pertinent information of which you are aware.
3. Carefully review the following list of medical problems (NEUROLOGICAL) and identify which ones you or one of your genetic relatives have or had. Please consider each condition carefully for each family member. If you and none of your family members have a history of the specific medical condition, please check "None".
 
Neurological None Self Children Mother Father Sibling Grandparents Aunt/Uncle Cousin
Migraines: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Mental Retardation: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Senility or Mental Deterioration before age 50: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Multiple Sclerosis: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Cerebral Palsy: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Neurofibromatosis: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Epilepsy / Seizures: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Attention Deficit Disorder / Hyperactivity: Yes Yes Yes Yes Yes Yes Yes Yes Yes
Autism / Asperger's: Yes Yes Yes