1.888.959.7712
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About us
The Lancaster Family
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How Embryo Donation and Adoption Works
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Contact
1.888.959.7712
About
Mission
About us
The Lancaster Family
How it Works
Services
How Embryo Donation and Adoption Works
Faqs
Requirements
Gallery
News
Resources
Blog
Give
Contact
1.888.959.7712
Apply Online
Contact Information
Phone
*
Phone Preferred Method
Check if preferred method of contact
Family Name
*
Physical Address
*
Address
City
State
ZIP
Mailing Address vs Physical Address
Check if Mailing Address is different from Physical Address
Mailing Address
Address
City
State
ZIP
Husband
Husband's Name
*
Phone
*
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Date of Birth
*
Height
*
Weight
*
Eye Color
*
Hair Color
*
Family History / Ancestry
African American
Asian
Caucasian
Hispanic
Middle Eastern
Native American
Pacific Islander
Mixed Race
Other
History / Ancestry - Other
Primary Email
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Job Title/Type of Work
*
Education Level
*
Wife
Wife's Name
*
Phone
*
Email Preferred Method
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Date of Birth
*
Height
*
Weight
*
Eye Color
*
Hair Color
*
Family History / Ancestry
African American
Asian
Caucasian
Hispanic
Middle Eastern
Native American
Pacific Islander
Mixed Race
Other
History / Ancestry - Other
Primary Email
*
Email Preferred Method
Check if preferred method of contact
Job Title/Type of Work
*
Education Level
*
Marriage and Parenthood
Date of Marriage
Husband Previous Marriage
Divorce
Wife Previous Marraige
Divorce
Children in the Home
Name
Age
Gender
Relationship
Pregnancies
Miscarriages
Do You Have a Current Home Study?
*
Yes
No
If Yes, Please Explain
Has Husband or Wife Ever Had Parental Rights Terminated for Any Reason?
*
Yes
No
If Yes, Please Explain
Fertility
How Long Have You as a Couple Been Unable to Conceive?
*
Have You Been to a Fertility Specialist?
*
Yes
No
If Yes, Please List
Name of Clinic
Phone
Address
City
State
Zip
Doctor's Name
Donating Family
Specify if You Have a Preference for Contact with Genetic/Donating Family
*
No Contact
Photos and Letters Through Cedar Park Only
Direct Contact Through Cedar Park and Direct Email
Open Adoption, You May Visit in Person
We Are Open to Discussing the Options
Upload Photos
Please Submit Photos of Husband and Wife
Drop files here or
Accepted file types: jpg, jpeg, gif, png, pdf, tiff, bmp.
Fertility Clinic
Name of Embryo Clinic where embryos were made.
*
Mailing Address
*
Address
City
State
ZIP
Email
*
Website
*
Phone
*
Name of Embryologist (if known)
Mailing Address
Address
City
State
ZIP
Email
Phone
Name of Doctor (if known)
Mailing Address
Address
City
State
ZIP
Email
Phone
Name of Nurse Practitioner (if known)
Mailing Address
Address
City
State
ZIP
Email
Phone
Approximate year made
*
DID YOU USE AN EGG OR SPERM DONOR?
*
Yes
No
THE PROCESS CAN TAKE SIX (6) MONTHS TO MATCH YOU WITH THE RIGHT FAMILY. PLEASE DESCRIBE YOUR SENSE OF URGENCY:
*
AS SOON AS POSSIBLE
WOULD LIKE TO MOVE ALONG FAIRLY QUICKLY
IT’S OKAY TO BE A YEAR OR MORE OUT FOR A MATCH
Agreement
By submitting this application, you attest that this information is true. A Non-Refundable Application Fee of $375 is required in order for your application to be considered for review.
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