Contact & Referrals | Divine Living Services

Participants & Families

Referring Yourself or a Family Member?

We know reaching out can feel like a big step. Our team will get back to you within 2 business days to have a relaxed, no-obligation chat about your needs.

Step 1 of 3: Participant details

Self or family referral form

Participant details

Full name Required

Date of birth Required

NDIS number Optional at this stage — leave blank if you're not sure.

Preferred contact method Required

Phone number Required

Email address

Residential suburb Required

Preferred language / interpreter required?

About your support needs

Which services are you interested in? Required

Support Coordination

Community Access

Daily Living

Nursing

Briefly describe what support you're looking for

Do you have a current NDIS plan? Required

Plan management type

Preferred start date / urgency

Emergency contact

Emergency contact name

Emergency contact number

I consent to being contacted by Divine Living Services about this referral. Required

I have read and accept the Privacy Policy. Required

Thanks — your referral has been received.

Our team will get back to you within 2 business days.

Support Coordinators & Plan Managers

Professional Referral

Send us a referral directly and our intake team will respond promptly with next steps and availability.

Step 1 of 3: Referrer details

Professional referral form

Referrer details

Referrer full name Required

Organisation name Required

Role Required

Phone number Required

Email address Required

Participant details

Participant full name Required

Date of birth Required

NDIS number Required

Plan start date

Plan review date

Plan management type Required

Primary disability / relevant diagnosis Optional — only include details relevant to service delivery.

Referral details

Services requested Required

Support Coordination

Community Access

Daily Living

Nursing

Funding availability confirmed? Required

Relevant support documents e.g. NDIS Plan, referral letter, care plan. Accepted formats: PDF, Word, JPG.

Urgency level Required

Additional notes / special considerations

I confirm the participant consents to this referral being made. Required

Thanks — the referral has been received.

Our intake team will respond promptly with next steps and availability.

Let's Start the Conversation