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Hurt Feelings Report Sample

HURT FEELINGS REPORT

To use this form, it must be physically placed in the hands of any Law Enforcement Officer

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY: PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:

S USC 301, Departmental Regulation, 10 USC 3013 and a log of other regulations too To assist whiners in documenting hurt feelings

Whiners should use this form to seek sympathy from someone who cares

Disclosure is voluntary, however, repeated whining may lead to your file being stamped "candy ass" or some other appropriate term

PART I - ADMINISTRATIVE DATA

A. WHINER'S NAME (Last, First, MI)

B. WHINER'S AGE

C. WHINER'S SEX

D. DATE OF REPORT

E. TYPE OF WHINE USED

F. NAME OF THE PERSON FILLING OUT THIS FORM

PART II - INCIDENT REPORT

A. DATE FEELINGS WERE HURT

B. TIME OF HURTFULNESS

C. LOCATION OF HURTFUL COMMENTS

D. WAS ANYONE SYMPATHETIC TO WHINER (Please include paid witnesses)

E. NAME OF PERSON WHO HURT YOUR PANSY ASS FEELINGS

F. HOW LONG DID YOU WHINE

G. WHICH FEELINGS WERE HURT

PART III - INJURY

(Circle all that apply)

1. WHICH EAR WERE THE HURTFULL WORDS SPOKEN INTO?

2. IS THERE PERMANENT FEELING DAMAGE?

 

LEFT

RIGHT

 

BOTH

 

YES

NO

MAYBE

3. DID YOU REQUIRE A "TISSUE" FOR TEARS?

 

4. HAS THIS RESULTED IN A TRAUMATIC BRAIN INJURY?

YES

NO

MULTIPLE

 

YES

NO

MAYBE

 

 

PART IV - REASON FOR

FILING THIS REPORT

 

 

 

 

 

(Mark all that apply)

 

 

 

I am thin skinned

 

 

The Dept needs to fix my problems

 

Two beers is not enough

 

 

I am a wimp

 

 

My feelings are easily hurt

 

My hands should be in my pockets

 

I have woman / man-like hormones

 

I didn't sign up for this

 

I was not offered a tissue

 

 

I am a crybaby

 

 

I was told that I am not a hero

 

Someone requested a tissue

 

 

I want my mommy

 

 

The weather is too cold

 

All of the above and more

 

NARRATIVE (Tell us in your own sissy words how your feelings were hurt, as if anyone cared)

PART V - AUTHENTICATION

A. PRINTED REPORTER NAME (if you wish to be labeled too)

B. SIGNATURE (are you sure about this?)

C. PRINTED WHINER NAME (you really are going out on a limb here) D. SIGNATURE OF WHINER (you have got to be shitting me!)

We, as the Dept, take hurt feelings seriously. If you don't have someone who can give you a hug and make things all better, please let us know and we will promptly dispatch a "hugger" to you ASAP. In the event a "hugger cannot be found, an EMS Team will be dispatched to soak your socks in coal oil to prevent ants from crawling up your leg and eating their way up your candy ass. If you are in need of supplemental support, upon written request, we will make every reasonable effort to prvide you with a "blankie", a "binky" and/or a bottle if you so desire.

⇓ PDF File

Instructions on Utilizing Hurt Feelings Report

Once you have the Hurt Feelings Report form in hand, it's important to fill it out completely and accurately. This process will help ensure that your feelings are documented properly. After submission, the report will be reviewed by the appropriate authorities.

  1. Begin with Part I - Administrative Data. Fill in your name in the format of Last, First, MI.
  2. Provide your age in the designated space.
  3. Indicate your sex by checking the appropriate box.
  4. Write the date you are filling out the report.
  5. Specify the type of whine used during the incident.
  6. Include the name of the person filling out the form if it is not you.
  1. Move to Part II - Incident Report. Record the date when your feelings were hurt.
  2. Note the time the hurtful comments were made.
  3. Describe the location where the comments took place.
  4. Indicate if anyone was sympathetic to you, including paid witnesses.
  5. Write the name of the person who hurt your feelings.
  6. Explain how long you whined about the incident.
  7. Specify which feelings were hurt.
  1. Proceed to Part III - Injury. Circle the ear where the hurtful words were spoken.
  2. Indicate if there is permanent feeling damage by checking yes, no, or maybe.
  3. State whether you required a tissue for tears.
  4. Answer if this incident resulted in a traumatic brain injury.
  1. In Part IV - Reason for Filing This Report, mark all applicable reasons for your feelings being hurt.
  2. Provide a narrative explaining how your feelings were hurt in your own words.
  1. Finally, complete Part V - Authentication. Print your name if you wish to be labeled.
  2. Sign the report to confirm your submission.
  3. Print your name again as the whiner.
  4. Sign again as the whiner to finalize the document.

After you have completed the form, make sure to physically hand it to any Law Enforcement Officer. This step is crucial for the report to be processed. If you need additional support, don't hesitate to reach out for assistance.

Misconceptions

Misconceptions about the Hurt Feelings Report form can lead to misunderstandings about its purpose and use. Here are ten common misconceptions clarified:

  1. The form is mandatory for reporting hurt feelings. Many believe that using this form is required. In reality, it is voluntary and intended for those who wish to document their feelings.
  2. Submitting the form guarantees a response. Some think that filling out the report will automatically prompt a response from law enforcement. However, there is no guarantee of action taken based solely on this report.
  3. The form is only for serious incidents. Many assume it is meant only for significant emotional trauma. In fact, it can be used for any situation where someone feels their feelings were hurt.
  4. Law enforcement officers take the report seriously. It is a common belief that officers will treat every submission with utmost seriousness. While they must acknowledge the form, the content may be viewed with skepticism.
  5. All reports are confidential. Some individuals think their submissions will remain completely confidential. However, there may be circumstances where information could be disclosed.
  6. The form is a legitimate legal document. Many view it as an official legal form. It is not a legal document but rather a humorous way to express feelings.
  7. People will be punished for their actions. There is a misconception that the form will lead to disciplinary action against those who hurt feelings. This is not the intended purpose of the report.
  8. Using the form is a sign of weakness. Some feel that filling out the report indicates personal weakness. In truth, it can be a way for individuals to express their emotions and seek support.
  9. There is a limit to how many times one can submit the form. Many think that repeated submissions will lead to penalties. The form can be submitted as often as desired, though it may be viewed less favorably over time.
  10. All submissions will receive a "hugger" or support. Some believe that every report will result in immediate emotional support. While the department may offer assistance, it is not guaranteed for every report.

Understanding these misconceptions can help individuals navigate the use of the Hurt Feelings Report form more effectively.

Documents used along the form

When dealing with sensitive situations, it’s essential to have the right forms and documents at your disposal. Along with the Hurt Feelings Report, several other documents can help streamline the process and ensure that everyone involved feels heard and supported. Here’s a list of some commonly used forms that complement the Hurt Feelings Report.

  • Sympathy Request Form: This form allows individuals to formally request sympathy from peers or supervisors. It can help clarify the nature of their feelings and the support they seek.
  • Incident Documentation Form: This document is used to provide a detailed account of the incident that led to hurt feelings. It includes sections for dates, times, and descriptions of events, ensuring all necessary information is captured.
  • Emotional Support Request Form: Designed for those who feel they need additional emotional support, this form allows individuals to specify their needs and preferences regarding assistance.
  • Witness Statement Form: If there were witnesses to the incident, this form collects their statements. It helps provide a fuller picture of the situation and can be crucial for understanding the context.
  • Follow-Up Feedback Form: After the initial report, this form gathers feedback on how the situation was handled. It encourages ongoing dialogue and helps improve future processes.
  • Residential Lease Agreement: This form outlines essential terms and conditions between landlords and tenants, ensuring both parties' rights and responsibilities are clearly defined, vital for a secure and effective rental relationship. For more information, visit All Ohio Forms.
  • Resolution Plan Template: This document outlines a proposed plan for resolving the issues raised in the Hurt Feelings Report. It encourages collaboration and constructive solutions.
  • Grievance Form: If the hurt feelings escalate to a more serious issue, this form allows individuals to formally lodge a grievance. It’s a critical step in addressing ongoing concerns.

Having these forms on hand not only aids in documenting feelings and incidents but also fosters an environment of understanding and support. By utilizing these resources, individuals can navigate their experiences more effectively, ensuring that their voices are heard and their feelings validated.