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Fill Out a Valid Hurt Feelings Report Form

The Hurt Feelings Report form is designed for individuals who wish to document their emotional distress in a structured manner. It serves as a tool for expressing grievances and seeking empathy from others, particularly law enforcement officers. If you feel your feelings have been hurt, consider filling out the form by clicking the button below.

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Table of Contents

Form Overview

Fact Name	Details
Form Purpose	This form assists individuals in documenting feelings of hurt to seek sympathy.
Submission Requirement	The form must be physically handed to a Law Enforcement Officer for it to be valid.
Privacy Act Compliance	The form is governed by the Privacy Act of 1974, ensuring data protection.
Voluntary Disclosure	While disclosure is voluntary, repeated submissions may lead to a derogatory label.
Incident Reporting	Section II requires details about the incident, including date, time, and location.
Injury Assessment	Part III allows the whiner to assess if there is permanent feeling damage or if tissues were needed.
Reasons for Filing	Multiple reasons can be marked, such as being thin-skinned or needing a tissue.
Narrative Section	The form includes a narrative section for individuals to describe their feelings in detail.
Support Offer	The department offers supplemental support, including a "hugger" or comfort items upon request.

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Documents used along the form

When submitting a Hurt Feelings Report, several other forms and documents may be useful. Each of these documents serves a different purpose and can help clarify the situation or provide additional context. Below is a list of these forms.

Incident Report Form: This form details the specific events leading to the hurt feelings. It includes information about the time, place, and individuals involved in the incident.
Witness Statement: A witness statement provides an account from someone who observed the incident. This can help support the claims made in the Hurt Feelings Report.
Emotional Impact Statement: This document allows the individual to express how the incident has affected their emotional well-being. It focuses on feelings rather than events.
Support Request Form: If additional support is needed, this form can be filled out to request counseling or other resources to help cope with the situation.
Resolution Agreement: This form outlines any agreements made between parties involved in the incident. It can help clarify how the situation will be resolved moving forward.
Follow-Up Report: A follow-up report can be used to document any changes or developments after the initial report. This helps track progress and any ongoing issues.
Feedback Form: This form allows individuals to provide feedback on the process of submitting their report. It can help improve future handling of similar situations.

These documents can enhance the Hurt Feelings Report and provide a clearer picture of the situation. Each form plays a role in ensuring that concerns are addressed appropriately and thoroughly.

Document 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.