We appreciate your desire to give the priceless gift of parenthood to a family, while financially helping your own!

We will review your application, and will reach out to you shortly. Feel free to email us directly at info@blissSurrogacylosangeles.com with any questions you may have in regards to the application. We are here to assist you every step of the way!

You may use the 'Save and Continue Later' option at the bottom of this page to come back and finish your application at a later time.

Surrogate Application

Your Personal Details

Date of birth

Your Family & Living Situation

What are the names and ages of people living with you?

Your Health

Adult BMI Calculator
1. Height:
2. Weight:

Employment and Background

Your Surrogacy Journey

Multiples are very common with surrogacy. It is the industry standard to place two embryos into the uterus to increase the chances of a positive pregnancy. Knowing this information, please answer the following:

Termination and Fetal reduction can sometimes be physician recommended to ensure the safety and health of a surrogate and the baby. Physicians will not perform a termination or fetal reduction for the sex of a baby, however the physician may recommend due to a genetic abnormality.

Amniocentesis is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections, and also for sex determination, in which a small amount of amniotic fluid, which contains fetal tissues, is sampled from the amniotic sac surrounding a developing fetus, and then the fetal DNA is examined for genetic abnormalities.

Your Pregnancy History

Please list their details below.

Child #1

Child #2

Child #3

Child #4

Child #5

Health of the children:

About You

Describe your diet:

Please write at least one paragraph biography about yourself and your family.

This should include at least one headshot, one full body picture and one picture with family.


Bliss Surrogacy is committed to protecting and respecting your privacy. We will only use Your personal information to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as Well as other content that may be of interest to you. By checking this box, I give my Express written consent for Bliss Surrogacy to call, text, or email me with marketing Offers or other messages regarding services about which I have inquired at the Phone number I have provided.




As a surrogate, I felt valued and respected throughout the entire process. They carefully matched me with a loving and appreciative intended family, and their ongoing support made all the difference. Yvette who is an experienced surrogate herself, was there for me whenever I had a question or concern. She was full of great tips and advice! This agency truly cares about their surrogates and intended parents!

Harper and Noah

Picking Bliss Surrogacy was a fantastic choice for us. They made us feel at ease throughout the entire process. Our surrogate was amazing, and the care and support she received from was outstanding. We are extremely grateful to them for making our surrogacy journey smooth and unforgettable.


I feel incredibly blessed to have chosen Bliss Surrogacy for my surrogacy journey. Their team was there for me at every step. They matched me with a wonderful couple, and witnessing their joy as they welcomed their first child was a truly heartwarming experience.

Jennifer and Christopher

We highly recommend Bliss Surrogacy to anyone considering surrogacy. Their expertise, compassion, and attention to detail were evident from the start. They supported us every step of the way, providing valuable guidance and connecting us with an incredible surrogate. Sara and Yvette were there for us and our surrogate the entire time. The support and compassion they provided was way beyond our expectation!  Thanks to Bliss Surrogacy, our family is now complete, and we couldn't be happier!

Maya and Caleb

Choosing Bliss surrogacy Los Angeles as our agency was the best decision we made on our journey to parenthood. We initially decided to go with this agency because of their personal experience being involved in a surrogacy journey. We also learned that they screen their surrogates before they nshow us the possible matches. This really helped us feel much more confident! Their knowledgeable and dedicated team guided us through the entire process, addressing our concerns and providing emotional support. They matched us with an exceptional surrogate who shared our vision.

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