Diverse Services
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Refer to Diverse Services

The whole referral, done on this page.

Eligibility, diagnosis, risk, support level, funding, all captured in one form. No PDFs, no email attachments needed, no chasing forms across systems. We respond with a written assessment outcome within 24 hours of submission.

Start the form Our 24-hour promise
24h
Written assessment outcome
From a complete submission
48h
Pre-placement visit offered
Once the referral is accepted
7d
Typical move-in window
Subject to clinical readiness
365
Days on call
Duty manager every day
Referral form

Tell us about the service user.

Sections marked with * are required. The whole thing should take 8–12 minutes. Your browser will auto-save your draft so you can come back to it later.

1Referrer
2Service user
3Eligibility
4Diagnosis
5Risk
6Support & funding
7Submit

Section 1

About you (the referrer)

So we know who to come back to.

Section 2

About the service user

Use initials or a pseudonym at this stage if you prefer.

Section 3

Eligibility, does this service user fit our service?

Tick all that apply. At least one of the criteria below should apply.

Section 4

Diagnosis & clinical picture

We assess each referral clinically. Diagnosis shapes how we plan the placement.

Mental Health Act 1983 (as amended by the 2007 and 2025 Acts).

Section 5

Risk & safeguarding

Indicate the current level of each risk.

Risk area
None
Low
Medium
High
Risk to self (self-harm / suicide)
Risk to others (violence / aggression)
Fire-setting / property damage
Substance use (current)
Risk of exploitation / vulnerability
Risk of absconding / disengagement
Section 6

Support level, funding & timeline

Our pathway has four steps. Pick the closest match and we will discuss.

Section 7

Declarations & submit