Skip to main content

Clinicians: Help us shape the future of healthcare. Take the survey

Heidi AI
Log inGet Heidi free

Ask AI about Heidi:

Allied Health Professional Template

ACC7430 SAW Initial/Progress Report

A professional Allied Health Professional template for healthcare professionals.
Use this templateBrowse more templates
Browse more templates

About this template

Need a clear way to keep ACC updated on your client's Stay at Work progress? This ACC7430 template is designed to help New Zealand Stay at Work providers complete the initial assessment and ongoing progress reports in one template, with objectives, return-to-work plans, and rehabilitation activities. This template ensures every section is covered, saving time and improving documentation quality. Easily generate ACC-ready reports and streamline your workflow with this essential tool. This template is perfect for SAW lead providers managing the full reporting cycle.

Preview template

ACC7430 Stay at Work – Initial and Progress Report A Stay at Work (SAW) provider completes this form to update ACC on a client's progress towards returning to their pre-injury work. Submit this form to the ACC contact person or claims@acc.co.nz 1. Report stage [ ] Initial — Complete sections 1 to 7 and sign section 9 [x] Progress (number): 2 of 4 — Additionally complete section 8 and sign section 9. Only the current progress report is required. Date of this report: 22/05/2026 2. Client details Client name: Olivia Bennett Claim number: 10078523 Date of injury: 04/03/2026 Client email: o.bennett@citycuts.co.nz 3. Supplier Contact details Supplier company name: Capital City Occupational Health Service Delivery Company name: Capital City Occupational Health Lead Provider name: Jessica Reid Lead Provider email address: j.reid@capitalcityoh.co.nz Lead Provider discipline: Physiotherapist Lead Provider phone: 04 472 1834 4. Overall objectives What is the overall objective specified in the referral? [ ] Same job, same employer [x] Modified job, same employer [ ] New job, same employer [ ] Other Comment: Olivia is to remain at City Cuts Wellington in a modified version of her senior stylist role, with phased reintroduction of cutting tasks alongside continued colour and consultation work. The objective is full return to pre-injury duties once symptoms have settled and grip strength has recovered. 5. Relevant contacts involved in the client's rehabilitation Name of personRoleEmailPhoneDate of contactDr Naomi FosterGeneral Practitionern.foster@karoriaccessmed.co.nz04 476 228911/03/2026Megan ThompsonSalon Owner / Employermegan@citycuts.co.nz04 385 772018/03/2026Jessica ReidLead Provider / Physiotherapistj.reid@capitalcityoh.co.nz04 472 183418/03/2026Olivia BennettCliento.bennett@citycuts.co.nz027 481 629318/03/2026 6. Initial assessment Date of initial assessment: 18/03/2026 Return to work target date on referral: 27/05/2026 Return to work target date following assessment: 27/05/2026 Clinical reason for the new target date: Return to Work Plan: DatesDays to workHours per dayWork tasksDetails of restrictions and rehabilitation18/03/2026 - 31/03/202645Consultation, colour mixing and application, hair washing, blow dryingNo scissor work; thumb spica splint during work and overnight; ice and rest protocol01/04/2026 - 28/04/202646Phased reintroduction of cutting (maximum 2 clients per day) alongside colour and consultationContinue splint between cutting clients; physiotherapy 2/week; ergonomic scissor handle trial29/04/2026 - 26/05/202657Gradual increase to 5 cutting clients per dayContinue strengthening programme; ergonomic scissors as standard27/05/2026 onwards58Full pre-injury caseloadMaintenance exercises; 3-month follow-up review <u>Assessment summary of the client and the workplace</u> Brief injury history and functional presentation Olivia is a 38 year old senior stylist with 12 years at City Cuts Wellington. She presents with right-sided de Quervain's tenosynovitis confirmed clinically by her GP on 04/03/2026 and on ultrasound 12/03/2026. Symptoms developed gradually over three months and were attributed to repetitive scissor use through a busy summer season. At assessment she demonstrated pain on resisted thumb extension and abduction, a positive Finkelstein test, and mild swelling over the first dorsal compartment. She has continued working at reduced capacity since her GP first restricted her cutting duties on 11/03/2026. Physical Function: Reduced right grip strength (24 kg vs 32 kg left, Jamar dynamometer baseline). Wrist range of motion within normal limits but painful at end-range radial deviation. Painful pinch grip with scissors. Able to perform light salon tasks (consultation, hair washing, blow drying, colour) without symptom exacerbation. Cutting and styling limited to short bursts. Orebro score: 38, indicating low to moderate risk for future work disability. Main contributors are pain-related anxiety and concerns about financial impact. Medication: Diclofenac 25 mg twice daily as required (commenced 04/03/2026); paracetamol 500 mg PRN. Pain: Aching and sharp pain over the radial side of the right wrist, worse with thumb movement and gripping. NRS 4-5/10 at rest, 7/10 with scissor use. Symptoms ease with rest and splinting. Sleep: Disrupted in the first 2 weeks post-onset; improved with night splint and analgesia. Now averaging 6 to 7 hours uninterrupted. Transport: Self-drives to and from work. No transport limitations. Activities of Daily Living (ADLs): Mild limitation with kitchen tasks (opening jars, chopping) and personal care (styling own hair). Manages independently with minor adaptations. Psychosocial factors: Sole financial contributor for two school-aged children. Anxiety about loss of income and salon clientele. Supportive employer willing to accommodate task modifications. Medical certificate status Currently on a modified duties medical certificate from 11/03/2026, due for GP review 11/06/2026. Pre-injury role title Senior Stylist Normal working hours/days 40 hours per week, 5 days (Tuesday to Saturday), 8 hours per day. Work tasks of the role Consultation; shampooing and conditioning; cutting (scissors and clippers); colouring (mixing, application, processing); styling (blow drying, heat tools); end-of-day clean down; weekly stock and till duties. Physical and cognitive demands of the role Prolonged standing (6 to 7 hours per day); sustained shoulder elevation; repetitive precise hand and wrist movements; fine motor control with scissors and clippers; sustained pinch grip; arm endurance; visual focus; client communication; multitasking across concurrent appointments. Barriers and opportunities identified at assessment Barriers in engaging in the return to work programme or achieving a return to work: Symptom flare risk with full cutting caseload Limited workplace flexibility during peak Saturday trading Financial pressure to return to full hours quickly Difficulty reducing repetitive scissor work without losing established colour and cut clientele Opportunities to address these barriers and achieve a successful outcome: Supportive employer willing to allocate consultation and colour clients to Olivia while another stylist absorbs cutting demand Ergonomic scissor handles available through the salon's supplier Phased return plan agreed with employer Access to ACC-funded physiotherapy and splinting Olivia's strong technical skills allow a focus on higher-value colour work during the restricted period 7. Activities to help achieve the overall objective and address any identified barriers List of initial activitiesProposed completion date of the activityDetail the outcome of activity and how this will achieve the overall objectiveThumb spica splinting at work and overnight18/04/2026Symptom reduction during scissor use; supports gradual return to cuttingPhysiotherapy 2/week (eccentric loading, soft tissue work, ergonomic education)15/05/2026Restore pain-free function and grip strength to support return to full caseloadWorkplace observation and task modification advice25/03/2026Confirm safe task allocation and posture; advise on micro-breaksErgonomic scissor handle assessment and trial01/04/2026Reduce repetitive strain on the first dorsal compartment during cuttingPacing and self-management education08/04/2026Empower Olivia to manage workload and avoid symptom flares Is a Work Specific Functional Rehabilitation required as part of this service? [ ] Yes [x] No If yes, provide the reason the programme is required: 8. Progress report Please provide a progress update to ACC and/or make a request for further services. Date of report: 22/05/2026 Progress report number: 2 of 4 Progress since previous report: Olivia has maintained engagement with the SAW programme and continued at her modified hours. She progressed successfully through stages 1 and 2 of the return to work plan (consultation, colour, hair washing, and a phased reintroduction of cutting up to 2 clients per day from 01/04/2026). She experienced a symptom flare on 05/05/2026 following a particularly busy Saturday with 4 cutting clients booked. Pain returned to NRS 7/10 with associated mild wrist swelling. Cutting was paused for 7 days, with full splinting and analgesia. By 19/05/2026 she had resumed cutting at 2 clients per day with NRS 3/10 task-specific pain only. Grip strength has improved to 28 kg (from 24 kg at baseline). Physiotherapy ongoing; ergonomic scissor handles trialled and well-tolerated. The clinical team and employer agree a two week extension to the return to work timeline is appropriate. Current return to work target date: 10/06/2026 Has the return-to-work target date changed? [x] Yes [ ] No The original target of 27/05/2026 has been extended by two weeks to 10/06/2026 following a transient symptom flare on 05/05/2026 that required a 7 day reduction in cutting hours. Olivia, her employer, and the clinical team agree the extension allows for safer phased progression without risk of further flare. No structural change to the overall plan; only the timeline shifts. DatesDays to workHours per dayWork tasksDetails of restrictions and rehabilitation22/05/2026 - 02/06/2026572 to 3 cutting clients per day; balance with colour and consultationContinue splint between cutting clients; physiotherapy 1/week03/06/2026 - 09/06/2026584 cutting clients per dayMaintenance physiotherapy; ergonomic scissors as standard10/06/2026 onwards58Full pre-injury caseload3-month follow-up review Has the client's medical practitioner approved the return-to-work plan? (If yes, please submit with the report) [x] Yes [ ] No If no, please state why: Is a further service level requested? [x] No further service required [ ] SAW 2 — no prior approval required [ ] SAW 3 [ ] SAW Exceptional [ ] SAW Initial Functional Rehab [ ] SAW Follow-up Functional Rehab [ ] Other Provide a detailed reason for requesting additional services: 9. Provider declaration and signature I declare the information provided by me on this form is, to the best of my knowledge, accurate and complete. Provider name: Jessica Reid Provider discipline: Physiotherapist Signature: Date: 22/05/2026 When we collect, use and store information, we comply with the Privacy Act 2020 and the Health Information Privacy Code 2020. For further details see ACC's privacy policy, available at www.acc.co.nz. We use the information collected on this form to fulfil the requirements of the Accident Compensation Act 2001. Items for Clinician Review Section 6, Orebro score: stated verbally as "around thirty-eight" with no validated questionnaire attached; verify 38 reflects Olivia's documented Orebro Musculoskeletal Pain Screening Questionnaire score. Section 8, Progress report number: confirm this is report 2 of 4 against the original SAW service authorisation, as the X of Y was inferred from prior reporting cadence rather than explicitly stated in the audio.
Browse more templatesUse this template

How to use this template

Step 1: Download the template
1Step 1

Download the template

Get started by downloading the template to your device

Step 2: Customize to your needs
2Step 2

Customize to your needs

Tailor the template to match your specific requirements

Step 3: Deploy and share
3Step 3

Deploy and share

Implement your customized template and share with your team

Browse more templatesUse this template

Related Templates

Form

Client Consent Form

Heidi Team

Allied Health Professional, Australia

Note

ACC7431 Back to Work - initial and progress report

Heidi Team

Allied Health Professional, Australia

Start practicing with a partner

Care is better with Heidi
Use this template

Specialty

Allied Health Professional

Used

1 times

Type

Note

Last edited

29/05/2026

Created by

Heidi Team

Note

ACC266 Psychological services action plan

Heidi Team

Allied Health Professional, Australia

Heidi AI

Heidi. By your side.

© 2026 Heidi. All rights reserved.

Specialties

  • Family Medicine

  • Specialists

  • Nurses

  • Mental Health

  • Allied Health

  • Dentists

  • Veterinarians

  • Trainees

Compliance

  • Safety

  • Trust Center

  • AU/NZ

  • Canada

  • UK

  • GDPR

  • HIPAA

Product

  • Pricing

  • Changelog

  • Downloads

  • Heidi Guides

  • Help Centre

  • System Status

  • System Requirements

About Us

  • Contact Us

  • Company

  • Customer Stories

  • Media

  • Open Roles

    10+
  • People

  • Partnerships

Resources

  • Blog

  • ROI Calculator

  • Resource Centre

  • Template Community

  • FAQs

Legal

  • Privacy Policy

  • Terms of Service

  • Usage Policy

  • UKGDPR Policy

  • Accessibility