surrogacy lawyer

Client Intake Form

Please complete the form below for domestic surrogacy arrangements. The form takes about 10-15 minutes to complete. Please have everyone’s details handy before you start.

Once you have submitted the form, please book in for the consult.

    Are you:
    SurrogateIntended Parent

    Details of the Parties:

    INTENDED PARENT 1






    INTENDED PARENT 2



    Intended Parents Relationship Commencement Date

    Marriage Date (if applicable)

    SURROGATE






    SURROGATE'S PARTNER (including middle names) (if applicable)



    Surrogate and Partner Relationship Commencement Date

    Marriage Date (if applicable)

    How do the Parties know each other?

    DONORS (IF APPLICABLE) - ARE ANY EGG, SPERM OR EMBRYO DONORS INVOLVED?

    OTHER PARTY'S LAWYER (IF KNOWN)

    CHILDREN - OF THE SURROGATE, AND OF THE INTENDED PARENTS

    FERTILITY SPECIALIST & CLINIC

    CLINIC COUNSELLOR NAME (if applicable)

    INDEPENDENT PSYCHOLOGIST NAME (if applicable)

    Have you commenced counselling?

    Do you need Sarah to draft the Agreement? YesNo

    If the Agreement has been drafted, please email a copy to sarah@sarahjefford.com

    How did you hear about Sarah?

    Thank you! Please press Submit and then click below to book in for the consult.

    Contact Sarah

    Wurundjeri Country

    Unit 3, 9 Dawson Street, Coburg, Victoria

    PO Box 366, Batman VIC 3058