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  1. Full Name*
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  2. Substance Use
    You may present my profile to expectant mothers who have identified marijuana use during their pregnancy.*
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  3. You may present my profile to expectant mothers who have identified alcohol use after the first trimester of pregnancy.*
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  4. You may present my profile to expectant mothers who have identified any type of legally prescribed substance use, e.g., methadone, subutex, medications for treatment of mental health symptoms, etc.*
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  5. You may present my profile to expectant mothers who have identified any type of illegal substance use, e.g., cocaine, heroin, meth, etc.*
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  6. Please DO NOT present my profile to expectant mothers who have identified any form of substance use.*
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  7. Agency States
    You may present my profile to expectant mothers who live in Colorado, Delaware, and/or Oklahoma. I understand that the cost of legal and birth parent services in these states is exceptionally high ($17,000-$22000).*
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  8. Older Children
    You may present my profile to birthmothers interested in placing an older child (from 6 months to 3 years of age).*
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  9. Traumatic Circumstances
    You may present my profile to expectant mothers who have identified the pregnancy occurred as a result of rape.*
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  10. You may present my profile to expectant mothers who have identified the pregnancy occurred as a result of incest.*
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  11. You may present my profile to expectant mothers who have reported they have a condition pertaining to their mental health.*
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