Referrals – Diverse Universe Care Support

Refer to Diverse Universe Care Support

We believe that accessing the right help should be straightforward and stress-free. If you or someone you know is in need of our support services, we are here to make the referral process as seamless as possible.

Referral Application Form

Participant Full Name

Participant's Date of Birth

Does the Participant identify as

Participant's Gender

Participant Disability/ies

Participant's Address

Suburb

Postcode

State

Participant's Contact Number

Participant's Email

Does the participant or representative require an interpreter?

Emergency Contact Name

Emergency Contact Number

Emergency Contact Email

Referred By

Referrer's Full Name

Referrer Contact Number

Referrer Email

NDIS/TAC Number

NDIS/TAC Start Date

NDIS/TAC End Date

Payments are Managed By

Payment Manager Email

(Please ensure the correct category of NDIS funding exists in your NDIS plan for the service being requested.)

Please select one or more required services

Supported Independent Living (SIL) Medium Term Accommodation (MTA) Short Term Accommodation (STA)

Type of Support Required (Days & Time)

How did you heard about us?

Refer to Diverse Universe Care Support

Referral Application Form

1300 206 570

admin@ducs.au

Business Hours