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Surrogate Questionnaire

If you are interested in becoming a surrogate you may contact our office or download and print the Surrogate Questionnaire (Adobe Acrobat Reader is required and may be downloaded for free from here). Follow the instructions on the questionnaire and return the completed form to us via mail or confidential fax.

Alta Bates IVF Program provides the full range of infertility services, including IVF, ICSI, MESA, Donor Eggs, Gestational Surrogacy, IUI, Ovulation Induction and Reproductive Surgery. The program was established by Dr. Richard Chetkowski in 1984 and it operates in affiliation with Alta Bates Summit Medical Center in Berkeley, California. The Alta Bates IVF Program offers the best of clinical care to infertile couples, same-sex couples, single men and women in a warm, comfortable, and supportive community hospital setting. Each patient receives personalized care from a single highly experienced physician. Many of our patients have complex infertility factors or have failed treatments elsewhere, so they often benefit from the individualized care, meticulous attention to detail and the depth of clinical experience unique to our program.

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