Hurt Feelings Report Form – Fill Out and Use This PDF

Hurt Feelings Report Form is a set of guidelines for what to do if someone's feelings are hurt.

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Is your boss constantly breathing down your neck? Do you feel like you can't speak up in meetings without feeling judged? If so, you're not alone. A recent study found that 67 percent of workers reported feeling belittled or humiliated at work. And if these feelings start to affect your work performance, it's time to take action. One way to do that is by filling out a Hurt Feelings Report Form. The Hurt Feelings Report Form is a tool designed to help you communicate with your supervisor about the way they make you feel. The form allows you to outline the specific incidents that made you feel bad, and provides space for both parties to discuss ways to resolve the situation.

If you wish to first learn how much time you will need to fill out the hurt feelings report form and the number of pages it's got, here's some basic information that will be useful.

Question	Answer
Form Name	Hurt Feelings Report Form
Form Length	1 pages
Fillable?	Yes
Fillable fields	44
Avg. time to fill out	9 min 7 sec
Other names	butthurt report pdf, butthurt form, butthurt report, but hurt report form pdf

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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.

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You need to submit the LEFT, DID, YOU, REQUIRE, A, TISSUE, FOR, TEARS, YES MULTIPLE, NO, PART, IV, REASON, FOR, FILING, THIS, REPORT MAYBE, Mark, all, that, apply B, SIGNATURE, are, you, sure, about, this and PART, V, AUTHENTICATION box with the necessary information.

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