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The Hurt Feelings Report form aims to address and document instances of emotional distress in a lighthearted yet structured manner. Designed for individuals to express their grievances, this form requires the physical attention of a law enforcement officer. Users are prompted to provide personal information, such as their name and age, along with details about the incident that upset them. Specific sections include the time and location of the incident, who was involved, and how they felt during and after the experience. A unique feature of this report is the emphasis on the seriousness of the feelings involved—even if that might occasionally come across humorously. As part of the process, individuals are even invited to reflect on whether their feelings caused any lasting impact, and they can articulate their reasons for filing the report. The concluding sections encourage personal authenticity by asking for the names and signatures of both the reporter and the individual who feels wronged. Furthermore, there’s a promise for practical support, with a nod to compassion, by offering a 'hugger' if needed, underscoring that emotional well-being matters—even in the most unexpected scenarios.

Hurt Feelings Report Example

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.

Form Characteristics

Fact Name Description
Purpose The form assists individuals in documenting perceived emotional injuries.
Submission It must be physically handed to a law enforcement officer for it to be accepted.
Privacy Act Compliance The form complies with the Privacy Act of 1974, ensuring personal data is protected.
Voluntary Disclosure Filing is voluntary; however, repeated submissions could lead to informal labeling.
Whiner's Information The form collects personal details like name, age, and gender of the individual filing.
Incident Details Specifics about the time, place, and nature of the incident must be documented.
Sympathy Requirement It assesses whether the individual received sympathy at the time of the incident.
Injury Assessment The form includes a section for evaluating the severity of emotional injuries.
Reasons for Filing Individuals can select multiple reasons for their feelings being hurt.
Narrative Section A space is provided for the individual to express their feelings in detail.

Guidelines on Utilizing Hurt Feelings Report

Once you have your Hurt Feelings Report form ready, follow the steps outlined below to complete it accurately. Make sure to provide clear and honest answers throughout the process. Once finished, submit the form directly to a Law Enforcement Officer.

  1. PART I - ADMINISTRATIVE DATA
    • Enter the whiner's last name, first name, and middle initial.
    • Fill in the whiner's age.
    • Select the whiner's sex.
    • Write the date you are filling out the report.
    • Specify the type of whine used.
    • Provide the name of the person filling out this form.
  2. PART II - INCIDENT REPORT
    • Note the date when feelings were hurt.
    • Indicate the time of hurtfulness.
    • Describe the location where the hurtful comments were made.
    • State whether anyone was sympathetic to the whiner, including paid witnesses.
    • Write the name of the person who hurt your feelings.
    • Record how long you whined about the situation.
    • Identify which feelings were hurt.
  3. PART III - INJURY
    • Circle which ear was spoken into.
    • Indicate if there is permanent feeling damage by circling "Yes", "No", or "Maybe".
    • Specify if you required a tissue for tears.
    • State if this resulted in a traumatic brain injury by circling "Yes", "No", "Multiple", or "Maybe".
  4. PART IV - REASON FOR FILING THIS REPORT
    • Select all reasons that apply.
  5. NARRATIVE
    • Describe in your own words how your feelings were hurt.
  6. PART V - AUTHENTICATION
    • Print the reporter's name if you want to be identified.
    • Sign the form to confirm your submission.
    • Print the whiner's name.
    • Sign on behalf of the whiner.

After completing the form, ensure all sections are filled out. Your next steps involve handing it to a Law Enforcement Officer for processing. Take care in your submission as we are here to help with any additional support you might need.

What You Should Know About This Form

What is the purpose of the Hurt Feelings Report form?

The Hurt Feelings Report form is designed to help individuals express and document their feelings when they feel hurt or offended. Although the name may seem humorous, the purpose is to assist those looking for acknowledgment or sympathy for their emotional experiences. It encourages a process that allows people to communicate their feelings officially, which can help support officers understand the context of the situation.

Who should use this form?

This form is meant for any individual who feels their feelings have been hurt in a situation. While it may sound trivial, anyone experiencing emotional distress due to comments or actions from others can fill out this form. It is a way for them to voice their feelings and seek validation or sympathy from others, including law enforcement.

How do I submit the form, and who do I give it to?

The form must be physically handed to any law enforcement officer. It's essential to ensure that the officer receives the form directly to process it properly. Personal delivery underscores the seriousness of the feelings expressed and allows the officer to engage with the individual face-to-face, if necessary.

What if I don’t want to disclose my personal information?

Common mistakes

Filling out the Hurt Feelings Report form can be challenging, and people often make mistakes that can hinder their ability to have their concerns addressed. One common error occurs in Part I, where individuals neglect to fill in their full name. Omitting either the last name or the first name can cause confusion and delay in processing the report. Additionally, skipping the middle initial can lead to misidentification. Ensure that all personal details are entered accurately to avoid complications.

Another frequent mistake is failing to provide enough details in Part II, the Incident Report section. The report requires specific information about when and where feelings were hurt. Empty answers can result in a lack of understanding regarding the situation. For instance, not mentioning the exact date or time can make it difficult for investigators to follow up. The location should also be clearly described, as vague answers may lead to unnecessary questions down the road.

In Part III, many people misuse the options related to injury assessment. Some individuals might leave the 'How long did you whine?' question blank or provide an unclear timeframe. The form seeks clarity, and offering a specific duration can help paint a clearer picture of the emotional impact. Furthermore, inaccurate responses regarding whether a tissue was required can reflect poorly on the report’s credibility.

While filling out Part IV, it’s not uncommon for individuals to mark too many reasons for filing the report. Selecting "All of the above" without careful consideration may overshadow specific grievances, making it harder to address individual concerns. Tailor your selections to reflect the primary reason, as this can help prioritize the response.

Another mistake involves the narrative section, where individuals often fail to fully articulate how their feelings were hurt. Providing a vague or overly brief explanation may lead to further inquiries. Take the time to explain the situation clearly and descriptively. This detailed narrative is crucial for understanding the context of the hurt feelings.

Finally, many forget to sign their reports, as indicated in Part V. A signature is required to validate the report, confirming that the information is accurate and sincere. Failing to sign can result in the report being considered incomplete, which can prolong the process of receiving support. Always double-check that all necessary sections are filled out and that all required signatures are present before submitting the form.

Documents used along the form

The Hurt Feelings Report form is often accompanied by several other documents that aid individuals in documenting their experiences and seeking appropriate responses. Each document plays a unique role in the overall process, ensuring that emotional distress is formally acknowledged and addressed.

  • Incident Report Form: This document provides a structured way for individuals to detail the specifics of the incident. It typically includes sections for date, time, location, and witnesses, allowing for a comprehensive account of events.
  • Witness Statement Form: This form gathers testimonies from people present during the incident. Collecting accounts from various witnesses helps to establish the context and validate the emotions reported.
  • Emotional Distress Affidavit: An affidavit is a sworn statement that outlines the emotional impact of the incident on the individual. Signing it can add weight to the claims made in the Hurt Feelings Report.
  • Support Contact List: This document allows individuals to outline their support network. Identifying friends, family, or professionals who can provide emotional assistance can be crucial in navigating hurt feelings.
  • Counseling Referral Form: This form is used to connect individuals with mental health professionals. Seeking professional help can provide necessary support and guidance following emotional distress.
  • Follow-Up Report: A follow-up report is used to capture ongoing emotional impacts after an initial incident. This document typically requires updates on the individual’s feelings and any additional incidents that may have occurred.
  • Feedback Form: This form solicits comments about the response received from authorities regarding the hurt feelings claim. Gathering feedback can help improve future interactions and support systems.
  • Official Grievance Form: If formal action is deemed necessary, this document serves as a means to file a grievance related to workplace or personal issues. It outlines the nature of the grievance and desired outcomes.

These documents, used in conjunction with the Hurt Feelings Report form, create a more complete picture of an individual's emotional state and the circumstances surrounding their experience. Each form assists in documenting the narrative and ensuring proper attention is given to feelings of distress.

Similar forms

The Hurt Feelings Report form shares similarities with various other documents designed to express grievances, report incidents, or seek support. Here is a list of nine documents that are akin to this form, along with their similarities:

  • Incident Report Form: This form helps individuals document specific events where they experienced harm or mistreatment, just like the Hurt Feelings Report focuses on incidents that affected emotional well-being.
  • Grievance Form: Used in workplaces and schools, this form allows individuals to formally report issues that require attention. Both forms aim to validate feelings and seek resolution.
  • Feedback Form: Often utilized for customer service or workplace environments, it captures individuals' feelings about their experiences, similar to how the Hurt Feelings Report aims to gather details about emotional distress.
  • Complaint Form: This document is used for reporting complaints against services or behaviors. Both forms allow the individual to express feelings and seek acknowledgment of their pain.
  • Request for Support Form: Designed for those needing emotional or psychological help. Just as the Hurt Feelings Report invites sympathy, this form seeks assistance for emotional struggles.
  • Witness Statement Form: Typically used in legal contexts, this form captures accounts of incidents. While the focus is different, both involve documenting experiences related to feelings or events.
  • Counseling Intake Form: This form helps assess the emotional state of individuals seeking counseling. It collects information on feelings and the context of distress, mirroring the Hurt Feelings Report's purpose.
  • Trauma Report Form: Used to document experiences of trauma for veterans or victims, similar in its aim to articulate and acknowledge the impact of a negative experience.
  • Client Concern Form: This is often employed by organizations to capture client complaints or concerns. Like the Hurt Feelings Report, it provides a channel for individuals to express hurt and seek a resolution.

These documents, while varying in their specific focus and context, share a common goal: to validate emotions and provide mechanisms for individuals to express their experiences.

Dos and Don'ts

When filling out the Hurt Feelings Report form, keep these important tips in mind:

  • Do be honest. Clearly state your feelings without exaggeration. Honesty matters.
  • Don't take it lightly. While humor can help, remember that you are documenting an emotional experience.
  • Do provide details. The more specific you are about the incident, the better support you might receive.
  • Don't leave blank fields. Each section is important. Fill everything in to ensure the report is complete.
  • Do seek assistance if needed. If you're unsure about something, ask for help when completing the form.

By following these guidelines, you can ensure that your report is taken seriously and that your feelings are properly acknowledged.

Misconceptions

Misconceptions about the Hurt Feelings Report form often arise, leading to confusion about its purpose and use. Here are nine common misunderstandings:

  1. This form is mandatory. Many believe they must fill out this report. In reality, submission is voluntary and meant for those who feel their feelings have been significantly hurt.
  2. The report is only for serious incidents. Some think the form is reserved for severe cases. However, it can be used for any expression of hurt feelings, no matter how minor.
  3. Using this form is a sign of weakness. There is a perception that submitting a report indicates an inability to cope. On the contrary, it is a way to acknowledge and express emotions, which is a healthy practice.
  4. The form is always taken seriously by law enforcement. While officers must accept the report, they may not consider all submissions as warranting extensive action. Each situation is assessed individually.
  5. You cannot be sympathetic if you fill out the form. People often think that reporting feelings prevents them from receiving support. In fact, those who report may find more empathy and understanding.
  6. Your identity will be disclosed. Concerns about privacy are common. The form includes provisions that help protect personal information, allowing individuals to express their feelings without fear of public exposure.
  7. This form guarantees a response. While filing the report opens a channel for communication, it does not ensure that every submission will lead to a formal response or action taken by law enforcement.
  8. Only specific feelings can be documented. Some people think the report is limited to specific emotions. In reality, individuals can express a wide range of feelings, from sadness to frustration, using the form.
  9. The intent of the report is to mock individuals. Many misconstrue the tone of the wording as mocking. The primary goal is to provide an outlet for those feeling hurt, not to shame them for their emotions.

Understanding these misconceptions can promote more effective use of the Hurt Feelings Report form and help individuals feel more empowered in expressing their feelings.

Key takeaways

Understanding the Hurt Feelings Report Form is crucial for anyone who feels their emotions have been disregarded.

  • The form must be directly handed to a Law Enforcement Officer for proper processing.
  • The information required is meant to identify the individual experiencing hurt feelings, including their name, age, and gender.
  • It includes sections to report specific incidents, detailing when and where the hurtful comments occurred.
  • It is important to note that disclosing the information is voluntary, but it can lead to humorous labels if used excessively.
  • Filling out the reason for filing the report is a chance to reflect on personal sensitivities.
  • A narrative section allows individuals to describe their experience in their own words, although it is often met with skepticism.
  • The process emphasizes that emotional well-being is taken seriously, and support will be offered whenever necessary.