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Printable Hurt Feelings Report Template

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The Hurt Feelings Report form is an unusual yet intriguing document designed for individuals who feel their emotions have been unjustly harmed. This form is intended for use by anyone who believes they need to express their grievances to law enforcement. It requires personal information, including the name, age, and sex of the individual submitting the report, as well as details about the incident that caused the hurt feelings. The form prompts users to describe the situation, noting the date, time, and location of the hurtful comments. It even asks whether anyone offered sympathy during the incident. Additionally, the report includes sections that address the extent of the emotional injury, such as whether permanent damage was incurred and if a tissue was needed for tears. A unique aspect of the form is its candid acknowledgment of the reasons people might file a report, ranging from feeling overly sensitive to needing a comforting hug. With a touch of humor, the form also offers to dispatch a “hugger” or even an EMS team if necessary. This blend of seriousness and lightheartedness makes the Hurt Feelings Report a fascinating tool for understanding how individuals cope with emotional distress.

Common mistakes

  1. Inaccurate Personal Information: Many individuals fail to provide correct personal details, such as their name or age, which can lead to delays or complications in processing their report.

  2. Neglecting to Specify the Incident: Some people do not clearly describe the incident that caused their hurt feelings. Providing vague or incomplete information can hinder understanding of the situation.

  3. Missing Required Signatures: A common mistake is forgetting to sign the form. Without the necessary signatures, the report may be considered invalid.

  4. Failing to Identify Witnesses: When individuals do not include names of witnesses, it may limit the ability to corroborate their claims. This can impact the perceived validity of the report.

  5. Overlooking Emotional Impact: Some individuals may not circle all applicable emotional injuries. This oversight can lead to an incomplete representation of their feelings.

  6. Inaccurate Timing Details: Providing incorrect times for when the hurtful comments were made can create confusion. Accurate timing is essential for understanding the context of the incident.

  7. Ignoring the Narrative Section: Many individuals skip the narrative section or provide minimal details. This section is crucial for conveying the full scope of their experience and feelings.

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Key takeaways

Here are some key takeaways about filling out and using the Hurt Feelings Report form:

  • The form must be given directly to a Law Enforcement Officer.
  • It is designed to help individuals document their hurt feelings.
  • Providing information is voluntary, but excessive complaints may lead to a negative label.
  • Personal details, such as name and age, are required in the administrative section.
  • Details about the incident, including date, time, and location, should be accurately recorded.
  • Witnesses who showed sympathy can be included in the report.
  • Various feelings and injuries can be circled in the injury section.
  • A narrative section allows for a personal account of how feelings were hurt.
  • Authentication requires signatures from both the reporter and the individual whose feelings were hurt.

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.

Understanding Hurt Feelings Report

What is the purpose of the Hurt Feelings Report form?

The Hurt Feelings Report form serves as a tool for individuals to document instances where they feel their emotions have been hurt. It is intended to assist those seeking sympathy and support from others. While the process may seem light-hearted, the form aims to provide a structured way to express grievances, however trivial they may appear to some.

Who should fill out this form?

This form is designed for anyone who feels their feelings have been hurt and wishes to formally document the incident. It is particularly aimed at individuals who identify as "whiners" and are looking for acknowledgment of their emotional distress. If you believe your feelings warrant a report, you are encouraged to fill it out.

How do I submit the form?

To submit the Hurt Feelings Report, you must physically hand it to any Law Enforcement Officer. This requirement ensures that your report is officially recognized and documented. Simply fill out the necessary sections of the form and find an officer to present it to directly.

What information do I need to provide?

The form requires several key pieces of information, including:

  1. Your name and age
  2. The date and time your feelings were hurt
  3. The location of the incident
  4. The name of the person who hurt your feelings
  5. A narrative description of how your feelings were hurt

Additionally, there are sections to indicate the type of emotional injury you experienced and whether you required any physical comfort, such as tissues.

What happens after I submit the form?

After submission, your report will be reviewed by the appropriate department personnel. They take hurt feelings seriously, and if necessary, steps will be taken to address your concerns. In some cases, a "hugger" may be dispatched to provide emotional support. If that is not possible, alternative support measures may be arranged.

Is there any confidentiality with this report?

While the disclosure of information on the form is voluntary, it is important to note that repeated submissions may lead to informal labeling. The intent is not to undermine your feelings but rather to maintain a balance in the system. Personal information is handled with care, but it is advisable to consider the nature of your disclosures.

Can I request additional support?

Yes, if you find yourself in need of further assistance, you can request supplemental support in writing. The department is committed to making reasonable efforts to provide comforting items such as a "blankie," a "binky," or even a bottle if that would help you feel better. Your emotional well-being is a priority.

What if I feel embarrassed about filing this report?

Feeling embarrassed is completely natural, but it’s important to remember that everyone experiences hurt feelings at some point. The report is meant to be a light-hearted way to express those feelings and seek support. The department encourages you to embrace your vulnerability, as it can lead to healing and understanding.

How to Use Hurt Feelings Report

After completing the Hurt Feelings Report form, it is essential to submit it directly to a law enforcement officer. This ensures that your report is received and processed appropriately. The following steps will guide you through the process of filling out the form accurately.

  1. PART I - ADMINISTRATIVE DATA:
    • Write your name in the format: Last, First, Middle Initial.
    • Indicate your age.
    • Specify your sex.
    • Fill in the date of the report.
    • Describe the type of whine you are using.
    • Provide the name of the person filling out the form, if different from you.
  2. PART II - INCIDENT REPORT:
    • Record the date when your feelings were hurt.
    • Note the time when the hurtful comments were made.
    • Specify the location where the hurtful comments occurred.
    • Indicate if anyone was sympathetic to you, including paid witnesses.
    • Write the name of the person who hurt your feelings.
    • Explain how long you whined about the incident.
    • List which feelings were hurt.
  3. PART III - INJURY:
    • Circle the ear into which the hurtful words were spoken: Left, Right, or Both.
    • Indicate if there is permanent feeling damage: Yes, No, or Maybe.
    • State whether you required a tissue for your tears.
    • Specify if this incident resulted in a traumatic brain injury: Yes, No, Multiple, or Maybe.
  4. PART IV - REASON FOR FILING THIS REPORT:
    • Mark all reasons that apply from the provided list.
  5. NARRATIVE:
    • In your own words, explain how your feelings were hurt.
  6. PART V - AUTHENTICATION:
    • Print your name if you wish to be labeled.
    • Sign the report to confirm your submission.
    • Print your name again as the whiner.
    • Sign again as the whiner to finalize the report.

Once the form is completed, ensure that it is delivered to a law enforcement officer. They will take the necessary steps to address your report and provide any support you may need.