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Index
Become parents
Become a surrogate mother
Articles
The law in the Russian Federation
Law of the Kyrgyz Republic
About Kyrgyzstan
About Us
Contacts
РУС
Questionnaire
fill out to apply for surrogacy
Your full name
Your phone number
Country, city
Date of birth
Your height, mm
Your weight, kg
Yes
No
NС or Caesarean
Children (younger). List: age, weight and height at birth
Up to what age is breastfeeding (month)
Blood group and Rhesus (group / Rhesus)
Married
not married
Divorced
Marital status
Yes
No
Female-like problems (cyst, polyps, miscarriages, abortions)
Once a year
Every six months
Other
Visit to the gynecologist (how often)
Yes
No
Chronic diseases
Yes
No
Vaccinations (hepatitis B, rubella, whooping cough, etc.)
Ring
Pills
Spiral
Condoms
Contraception
Vaccination against avid (specify the date of vaccination or "no" if you did not)
Cycle (specify the number of days)
The first day of the last cycle (date)
Yes
No
Surrogacy experience
Yes
No
The presence of bad habits
Send a questionnaire
