Surrogacy Screening Process: What Happens Before Approval

After you apply to be a surrogate, screening usually brings together your pregnancy records, a background check, a psychological evaluation and fertility-clinic checks before treatment can begin. Some steps overlap, and matching can happen before the clinic’s final medical review. The practical question is what you need to do next: request a missing record, arrange childcare for an appointment, or wait for a particular person to review your file. Here’s how to find your place in the process and prepare without putting your family’s whole week on hold.

What happens after I submit my surrogate application?

Your application usually leads to a conversation about your health, pregnancy history, reasons for becoming a surrogate and availability for the next checks. I’m your initial contact at LittleBee. Tell me what would be difficult at home, too—night shifts, school pickup or a partner who needs notice to take time off. Those details belong in the conversation.

Before you start collecting paperwork, compare your situation with the surrogate requirements. For help with the form itself, see the surrogate application process.

Find your current step in the table below. The week ranges are examples from other U.S. programs’ published timelines. Your coordinator can give you the dates for your own appointments. The psychological appointment length describes a particular format, with report preparation afterward.

These rows are stages to recognize, rather than a calendar to add up. Records and background work can overlap; the intended parents’ clinic may do its final medical screening after a match. Read more about surrogate matching when you reach that point.

An accepted application means you can move to the stated next step. Before treatment, the medical, psychological and legal work still needs to be completed. ASRM’s recommendations¹ describe those parts of gestational surrogacy; the clinic reviews the full chart and its findings before medical clearance. The clinic review² continues beyond the appointment itself.

Which medical records should I gather—and what if something is missing?

Start with each pregnancy and the offices or hospitals that hold its records, then ask for the clinic’s exact document list. Include losses and related surgery, even when they happened somewhere other than your usual OB’s office. Your account matters, and the reviewers also need the chart: ASRM calls for a comprehensive medical, obstetric and social history¹.

For each pregnancy, note the approximate treatment dates, provider, birth hospital and the name you used then. Use that treatment name on the records request³, so the office can find the right chart. If you’ve forgotten an office’s name, check the birth hospital, old insurance history, your portal or your current OB for a lead.

The requested set may include:

• Prenatal records: visits, test results, diagnoses and treatment during pregnancy.
• Labor and delivery records: the delivery note and hospital course. After a C-section, ask for the operative report if requested; a discharge summary is a different document.
• Postpartum follow-up: recovery visits, follow-up for complications and care at a separate office.
• Other relevant care: current OB and primary-care records, medication lists, labs, imaging and specialist notes the clinic requests.

If a pregnancy had complications, include the notes showing what happened, how it was treated and how recovery went. Remembering “a long labor” or “blood pressure checks” can help the team ask the right questions, but the chart supplies the recorded delivery method and diagnoses.

A portal can be a useful starting point. If it contains the exact files requested, you can save another request. If it shows only part of the chart, request the missing files from the records office⁴. Write the date range and document names on the form: at some hospitals, leaving those fields blank can produce only the last two years of treatment or a summary rather than the files requested⁵. Write the pregnancy’s dates and the particular files needed.

Separate offices can hold separate parts of one pregnancy. A surrogate we will call Tania remembered a full-term birth, a long labor and repeated blood-pressure checks; she and her baby went home healthy. On March 18, the hospital records showed raised blood pressure around delivery and postpartum follow-up instructions. The clinic asked for prenatal and postpartum records to understand whether the concern had resolved. On March 21, the team identified the prenatal OB, delivery hospital and separate postpartum office. Delivery and operative documentation had arrived; postpartum notes were missing. Tania requested those notes through the postpartum provider’s portal, and the office confirmed receipt a few days later. On April 2, the notes arrived, giving the clinic a clearer picture for its judgment.

For Tania, the next task was finding the missing part of her file. Keep a simple tracker: pregnancy, exact document, provider, request date, acknowledgment, date the file arrived. Ask which files have arrived before requesting everything again. Check that the receiving clinic can open them, too.

I’d keep the sending instructions beside that tracker. Ask the receiving office which secure route and address it accepts⁶, verify the recipient, and ask about any fee before paying. Follow the record holder’s request form. Before signing a release, ask which files it covers, who can read them, what may be shared for matching and how long copies are kept. Keep full records and SSNs out of casual texts.

If a diagnosis or date looks wrong, point to the specific page and ask the original provider about its amendment process⁷. The provider reviews that request; you can ask for a copy and correction through its records office⁸. A missing or confusing chart entry needs follow-up, rather than a judgment about your honesty.

If an old record seems impossible to find, trace its holder first. An office may have moved, merged or changed its name, or stored old charts in another system. Ask about archives, a successor practice or a named custodian. If the office has closed and you have no lead, ask the state health department or medical board whether it can identify a record holder⁹¹⁰. Old files may no longer exist; retention rules vary¹¹. If the holder says files were destroyed or can’t be located, ask what dates and files it searched and whether it can confirm that in writing. Give that answer to the receiving clinic and ask what it can accept. Don’t keep requesting the same unavailable file or assume an OB letter will replace it.

Who gets a background check, and what will I be asked?

A surrogate background check may include you and your spouse or live-in partner; ask whether anyone else in your home is included before you gather their information. Screening programs differ. Your home support also comes up in the psychological evaluation; the report doesn’t replace that conversation. Talking with your partner early gives both of you time to find old addresses and ask about privacy, instead of meeting the request as a surprise.

You may be asked for your legal name, former names, date of birth, current and past addresses, government ID and signed permission for the check. A screening company may also request your SSN through its secure form. Surrogacy screening services¹² describe name and address searches alongside criminal and sex-offender checks. Other providers describe additional options¹³, including public legal records or financial searches. Ask what your actual package includes; background reports differ in what they contain¹⁴.

The purpose is to identify safety, trust or legal concerns that need attention, without asking you to have had a perfect life. Answer questions about arrests, charges, convictions, protective orders and unresolved cases accurately. If something needs explaining, ask which court documents would help. An old misdemeanor and an unresolved case raise different questions; criminal-record eligibility explains that decision in more detail. Hiding a matter you know about can create a trust problem even before its details are reviewed.

I’d get the privacy answers before entering sensitive information. You can ask in one conversation: “Which company runs this, who in my household is checked, what records are searched, who receives the report, how long is it kept, and how do I get a copy or correct an error?” Clarify what, if anything, intended parents receive. For an unexpected message asking for your SSN or ID, verify it using a phone number or website you already know is genuine¹⁵.

If something is wrong, first find out where the error happened. If your name or birth date was entered incorrectly, ask the organization that ordered the check whether it must request a corrected report¹⁶. If a court record belongs to someone else or its outcome is wrong, ask the report issuer for the dispute process. Get the report and any notice you received, identify the exact entry, provide ID or court documents through the agreed channel, and keep your messages and receipt confirmations. FTC guidance supports those checking and dispute steps¹⁷.

Alina had moved twice and used a shortened name at work. Her report included a criminal case involving another woman with a similar name and birth year. She felt embarrassed, but her coordinator directed her to the screening company’s dispute process. Alina supplied identity and address information, and the company corrected the report before matching continued.

A wrong match needs correction at the company that produced it. Where the Fair Credit Reporting Act applies to the report, it provides access to your file¹⁸ and a way to dispute inaccurate information¹⁹. Ask your coordinator how the correction affects your next screening step.

How do I prepare for the psychological evaluation?

Prepare for an honest conversation about your reasons for surrogacy, mental-health history, relationships and support at home, with private time for any testing. This is a chance to discuss what the pregnancy could ask of you and your family. I’d write down the parts you’re unsure about, including your children’s needs, work, communication with intended parents and support if something becomes difficult.

ASRM recommends involving your partner or primary support person or family member¹ in the evaluation and counseling. That person may attend only part of the appointment. Ask who should join, when they’re needed and whether the session is in person or by video before either of you arranges time off.

Confirm what the booked time includes. Some providers describe about two hours for an interview and testing together²⁰. One disclosed assessment format²¹ leaves scoring, interpretation and the report until afterward. Your partner may join the interview while you complete testing on your own²². Allow for the appointment itself, then ask when the provider will send the report.

For a video appointment, staying home saves travel if someone else can care for the children and you have a private room. If home can’t offer quiet or the appointment requires a visit, arrange another private location or travel to the provider; that takes more planning but avoids trying to complete an assessment while handling interruptions. Confirm the provider’s requirements before choosing a location. Check the video connection beforehand, and have your questions and requested forms nearby.

You don’t need to rehearse reassuring answers. Explain your actual history and what support is available, including what is still uncertain. Read the surrogate psychological evaluation guide for the topics and assessment details; partner agreement has its own guide. Before leaving the appointment, ask who receives the report and who will tell you when this step is complete.

What should I expect at the fertility-clinic visit?

Expect the clinic to review your history and arrange an examination and the tests it needs, then review those findings with your records before medical clearance. The visit may include a discussion of your history, an exam, bloodwork and a uterine assessment². ASRM’s screening recommendations¹ place those checks within a broader medical evaluation. Your fertility clinic decides whether your medical history and findings meet its criteria.

Before the visit, confirm the actual appointment instructions:

• Which records and forms should arrive beforehand, and which are still missing?
• What medication list or other information should you bring?
• Are there instructions about eating, drinking, your cycle or any test preparation?
• Does your spouse or partner need to attend or provide separate samples?
• How long should you allow at the clinic, and who will contact you afterward?

A support person coming along and a partner needing tests are different arrangements. Some clinics screen both the carrier and her spouse or partner²³; ask what applies to your appointment. Confirm whether someone needs their own booking before arranging a shared day off.

I’d sort out childcare and transport before booking travel. Check the location, arrival time, transport and childcare, then confirm which travel or lodging arrangements the coordinator is handling and which you need to make. If the date would leave your family without help, raise that before booking. Being available for screening shouldn’t mean silently agreeing to an arrangement you can’t manage.

The medical screening guide covers the tests in more detail. For questions about your current medicines, see surrogacy medications and bring the question to the clinic before changing anything. Infection-related screening also has a separate guide. At the end of the visit, find out whether the clinic is waiting for a test result, a record or another reviewer, so you know what happens after you go home.

When do insurance review and legal clearance happen?

Have your insurance information ready early, and expect the legal work and treatment clearances to be coordinated with your match and clinic. The order can differ between programs. Gathering a policy document can happen while another review is underway; signing a completed agreement is a later task with its own reviewer.

For insurance, keep your current card and full policy booklet or Evidence of Coverage available. The card identifies the plan; the full document is what lets a reviewer examine its terms. Ask for a written assessment of the full policy’s terms²⁴. If you only have the card, ask your insurer or employer’s benefits contact how to obtain the full plan document.

I’d ask who is handling the review and what document they still need, then keep the written result with your records. Tell the coordinator if your job or plan changes while screening continues, so the review uses the plan you’ll actually have. The surrogate insurance review guide explains the coverage questions; here, your job is to supply the requested documents and know whether that review is still open.

For legal preparation, have your questions ready for your own attorney: what the agreement asks of you, what happens if plans change and which matters you want explained before signing. ASRM recommends psychological evaluation before legal counseling and signing¹, independent counsel, and a fully signed agreement, legal clearance letter and informed consent before treatment begins. Ask your coordinator and attorney which part of that work is still open.

A clinic may also require completed screening and the agreement before its physician signs off on eligibility and transfer medicines can begin²⁵. Wait for the treatment team’s instructions about starting medicines. The legal clearance guide explains that stage in detail. Before arranging treatment leave, confirm whether the remaining item is insurance review, a signed document, a clearance letter or clinic instructions, and who is responsible for it.

How long can screening take, and what does “pending” mean?

The stage you’re waiting on matters more than the number of weeks since you applied. The table’s 4–8 weeks covers initial agency screening in other programs’ examples; 2–4 weeks covers post-match clinic records review and medical screening in others. Gathering missing records can be part of that second range. Matching, legal work and overlapping checks make it misleading to add the two ranges into one finish date.

If you’ve heard “pending” without an explanation, ask which of these situations applies:

If the missing item is a medical record, use the steps in the records section. A clinic visit can be followed by further chart review². Ask for the exact item and a next check-in date, rather than repeatedly asking whether you’re approved.

While records are being gathered, ask which other tasks you can complete; a clinic may still need the full history before its review is finished. I’d give possible helpers a heads-up now, while leaving dates flexible. Waiting for a confirmed appointment avoids changing paid arrangements, but can leave fewer childcare or work-cover options. Confirm the appointment before fixing nonrefundable travel. For the stages after screening, see the surrogacy timeline. You can also browse our Surrogacy Process guides.

Ready to take the first step? Start your LittleBee surrogate application with your age, state, pregnancy history and availability. Tell me what you’re considering and what would be hard to arrange at home, and we can talk about the next step. If you have a question first, email support@littlebeesurrogacy.com.

References

1. Recommendations for practices using gestational carriers: a committee opinion (2022) — asrm.org, 2022
2. What to Expect During Gestational Carrier Screening – A Guide From FCLV — fertilitycenterlv.com
3. Medical Records — ucsfhealth.org
4. Medical Records FAQ — dukehealth.org, 2026-08-24
5. Instructions for Completing the Authorization for Release of Information Form — dukehealth.org, 2026-03
6. Send Your Medical Records to Duke Health — dukehealth.org, 2026-07-20
7. Request to Change Medical Records — dukehealth.org, accessed 2026-10-09
8. Your Medical Records — hhs.gov, 2025-05-30
9. Where to Find Medical Records for Closed Hospitals in New York State — health.ny.gov, accessed 2026-10-09
10. 303. My physician closed their office. How do I get my medical records? — tmb.texas.gov
11. Does the HIPAA Privacy Rule require covered entities to keep patients’ medical records for any period of time? — hhs.gov, 2013-07-26
12. Surrogate and Intended Parent Checks — diligentdata.com, accessed 2026-06-01
13. Surrogate Background Investigations | Crossroads Investigations — xinvestigations.com, accessed 2026-10-06
14. What are specialty consumer reporting agencies and what types of information do they collect? | Consumer Financial Protection Bureau — consumerfinance.gov, 2025-09-05
15. How To Recognize and Avoid Phishing Scams — consumer.ftc.gov, 2022-09
16. How do I update my personal information on a report? — help.checkr.com, 2026-09-09
17. Disputing Errors on Your Tenant Background Check Report — consumer.ftc.gov, accessed 2024-03-07
18. U.S.C. Title 15 – COMMERCE AND TRADE — govinfo.gov
19. U.S.C. Title 15 – COMMERCE AND TRADE — govinfo.gov
20. Gestational Carrier Assessment — fertilitypsychologist.com
21. Psychological Testing & Diagnostic Evaluations — cognitive-assessment.com, accessed 2026-10-09
22. EVALUATION — brittadinsmore.com
23. Using a Gestational Carrier — nashvillefertility.com
24. POLICY VALIDATION — artrisksolutions.com
25. Gestational Carrier Program — froedtert.com

About this guide: Prepared with the sources listed above. Reviewed October 9, 2026.