Hurt Feelings Report Template Access Hurt Feelings Report Editor Now

Hurt Feelings Report Template

The Hurt Feelings Report form, often viewed with a mix of humor and controversy, is purportedly designed to document instances where individuals feel their emotions have been negatively impacted, offering a structured way for "whiners" to express grievances and seek further counsel or leadership. It touches on a variety of reasons for filling out the report, from being thin-skinned to requiring a "blankey," and provides a space for detailing the incident. If you believe your emotions have taken a hit and need to formalize your feelings, considering filling out the form by clicking the button below.

Access Hurt Feelings Report Editor Now
Table of Contents

In the realm of addressing emotional concerns within structured organizations, the Hurt Feelings Report form presents a unique approach. Crafted with an underlying tone of satire, this form ostensibly offers a structured method for individuals, notably within the military, to document instances where their feelings have been injured. According to the form, its creation is supported by various authoritative sources such as the Departmental Regulations, the Secretary of the Army, and even an Executive Order. The principal purpose is humorously stated as aiding "whiners" in officially noting their grievances while also signaling to leadership which individuals may require additional attention, whether through counseling, enhanced leadership interaction, or extra duties. It covers a gamut of information, from administrative data about the aggrieved party to a detailed incident report, including the specific occasion of hurt feelings, the parties involved, and the nature of the emotional injury. Remarkably, the form includes checkboxes for situations ranging from the need for a tissue to manage tears to queries about permanent emotional damage, and even the facetiously considerate offer to dispatch a "hugger" in the absence of immediate personal support. This document, while on its surface might seem trivial or mocking, opens a dialogue on the importance of emotional well-being, the methods to address grievances within a highly hierarchical institution like the military, and perhaps the broader question of how modern organizations can balance seriousness with levity in managing personnel concerns.

Form Preview

HURT FEELINGS REPORT

For use of this form, see FM 22-102; the proponent agency is TRADOC

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY: 5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army and E.O. 9397 (SSN)

PRINCIPAL PURPOSE: To assist whiners in documenting hurt feelings, and to provide leaders with a list of soldiers who require additional counseling, NCO leadership, and extra duty..

ROUTINE USES: For subordinate leader development IAW FM 22-102. Leaders & whiners should use this form as necessary.

DISCLOSURE: Disclosure is voluntary, but repeated disclosure may result in a DA Form 779-1A, Report of Wall To Wall Counseling

PART I – ADMINISTRATIVE DATA

A. WHINER’S NAME (Last, First, MI)

B. RANK/GRADE

C. SOCIAL SECURITY NUMBER

D. DATE OF REPORT

E. ORGANIZATION

F. NAME & TITLE OF THE PERSON FILLING OUT THIS FORM

PART II – INCIDENT REPORT

A. DATE FEELINGS WERE HURT

 

B. TIME OF HURTFULNESS

C. LOCATION OF HURTFUL INCIDENT

 

D. NCO OR OFFICER SYMPATHETIC TO WHINER

 

 

 

 

 

 

E. NAME OF REAL MAN/WOMAN WHO HURT YOUR SENSITIVE

F. RANK/GRADE

 

G. ORGANIZATION (if different from 1e above)

FEELINGS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E. INJURY (Mark all that apply)

 

 

 

 

1. WHICH EAR WERE THE WORDS OF HURTFULNESS 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

 

 

 

 

 

 

 

 

 

F. REASON FOR FILING THIS REPORT (Mark all that apply)

I am thin skinned

I am a wimp

Ihave woman/manlike hormones

Iam a crybaby

Iwant my mommy

The Army needs to fix my problems

My feelings are easily hurt

I didn't sign up for this

I was told that I am not a hero

The weather is to cold

Two beers is not enough

My hands should be in my pockets

I was not offered a post brief

Someone requested a post brief

All of the above and more

G. NARRATIVE (Tell us in your own sissy words how your feelings were hurt.)

PART III ‐ AUTHENTICATION

a. PRINTED NAME OF REAL MAN/WOMAN

b. SIGNATURE

c. PRINTED NAME OF WHINER

d. SIGNATURE

We, as the Army, 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 we are unable to find a "hugger" we will notify the fire department and request that they send fire personnel to your location. If you are in need of supplemental support, upon written request, we will make every reasonable effort to provide you with a "blankey", a "binky" and/or a bottle if you so desire.

DA FORM IMT WF1, APRIL 2009

EDITION OF APRIL 1989 IS OBSELETE

Form Breakdown

Fact Number Detail
1 The Hurt Feelings Report is a fictional form designed for humorous or satirical purposes, often circulated within military contexts.
2 Authority for the form is cited as 5 USC 301, Departmental Regulations; 10 USC 3013, Secretary of the Army and E.O. 9397 (SSN).
3 The primary purpose is stated as assisting individuals in documenting hurt feelings, and providing leaders with a list of soldiers needing additional counselling and leadership.
4 Routine uses include development for subordinate leaders in accordance with FM 22-102.
5 Disclosure of the form is voluntary, but repeated disclosure may lead to a Report of Wall To Wall Counseling.
6 The form humorously asks for the identification of which ear heard the hurtful words and if there is permanent feeling damage.
7 Reasons for filing the report include a range of sarcastic options such as being thin-skinned, a crybaby, or complaining about the weather being too cold.
8 The narrative section invites the individual to describe in their own "sissy words" how their feelings were hurt.
9 The form concludes with a humorous offer to dispatch a "hugger" if the individual does not have someone to make things better, potentially involving the fire department if needed.
10 Despite its appearance, this form is not an official document and should not be used in any official capacity.

Guidelines on Filling in Hurt Feelings Report

Filling out the Hurt Feelings Report form is uncomplicated when done methodically. Though it might seem a bit daunting at first glance, this step-by-step guide aims to streamline the process. Whether for individual reflection or leadership insight, accurately completing this form is essential. Let's dive into the steps needed to fill out the form, ensuring every necessary detail is captured accurately and effectively.

  1. Begin with PART I – ADMINISTRATIVE DATA. Here you will detail personal information and the context of the report.
    • A. WHINER’S NAME: Enter the full name (Last, First, MI) of the individual who felt aggrieved.
    • B. RANK/GRADE: Specify the military rank or civilian grade.
    • C. SOCIAL SECURITY NUMBER: Fill in the SSN with care. Given the sensitive nature of this information, ensure the report is kept secure.
    • D. DATE OF REPORT: Mark the date when this report is being filled out.
    • E. ORGANIZATION: Enter the name of the military unit or office.
    • F. NAME & TITLE OF THE PERSON FILLING OUT THIS FORM: Write down the name and title if someone other than the aggrieved is completing the form.
  2. Proceed to PART II – INCIDENT REPORT. This section gathers specifics about the incident that led to hurt feelings.
    • A. DATE FEELINGS WERE HURT: Indicate the date on which the incident occurred.
    • B. TIME OF HURTFULNESS: Specify the time when the feelings were hurt.
    • C. LOCATION OF HURTFUL INCIDENT: Describe where the incident took place.
    • D. NCO OR OFFICER SYMPATHETIC TO WHINER: Name any Non-Commissioned Officer or officer who was sympathetic to the individual's feelings.
    • E. NAME OF REAL MAN/WOMAN WHO HURT YOUR SENSITIVE FEELINGS: Clearly state the name of the person responsible for the hurt feelings.
    • For sections F. RANK/GRADE and G. ORGANIZATION, repeat the process as in PART I, but now regarding the individual who caused the hurt feelings.
    • Under E. INJURY, check the appropriate boxes regarding how the hurt feelings have affected you and elaborate if necessary.
    • In F. REASON FOR FILING THIS REPORT, tick all reasons that apply to why the form is being filled out.
    • The G. NARRATIVE section lets you describe, in your own words, how your feelings were hurt. Be as detailed as necessary to convey the incident accurately.
  3. The final step is PART III – AUTHENTICATION. This part is about verifying the information provided in the report.
    • a. PRINTED NAME OF REAL MAN/WOMAN: The individual accused of causing the hurt feelings must print their name.
    • b. SIGNATURE: The same individual must sign the form to acknowledge their understanding of the report.
    • c. PRINTED NAME OF WHINER: The person filing the report must print their name.
    • d. SIGNATURE: Lastly, signing the form to validate its completion and the truthfulness of the provided information.

Upon completing these steps, the Hurt Feelings Report form captures a clear and thorough account of the incident, allowing for appropriate follow-up actions. Understanding the nuances of how feelings were hurt and the context surrounding these incidents can significantly aid leaders in addressing and mitigating future occurrences, contributing to a more understanding and supportive environment.

Learn More on Hurt Feelings Report

What is the purpose of the Hurt Feelings Report form?

The Hurt Feelings Report form is designed as a tool to assist individuals, often humorously referred to as "whiners," in documenting incidents where their feelings were hurt. The objective is also to provide leaders with information about those under their command who may require additional support, counseling, leadership from Non-Commissioned Officers (NCOs), or extra duties. It aims at supporting subordinate leader development in a comedic and exaggerated manner.

Who should fill out the Hurt Feelings Report form?

Both leaders and individuals who have experienced hurt feelings ("whiners") are encouraged to use the form as needed. It is intended for use within a military context, specifically referring to soldiers and their superiors. The person who felt their feelings were hurt fills out the majority of the form, while a leader or superior may complete sections related to leadership actions or observations.

What kind of information is required on the form?

The Hurt Feelings Report form gathers a variety of information, categorized into three main parts:

  1. Administrative Data: Includes the individual's name, rank or grade, Social Security Number (SSN), date of the report, and the organization they belong to. It also asks for the name and title of the person filling out the form, which could be the individual themselves or a superior.
  2. Incident Report: This section requires details about the incident that led to hurt feelings, including the date, time, location of the incident, and specifics about the person whose actions caused the hurt feelings. It humorously asks which ear heard the hurtful comments, whether permanent feeling damage occurred, and if a tissue was required for tears.
  3. Authentication: Both the individual with hurt feelings and the 'real man/woman' (often a term humorously used for someone involved in managing the situation) are required to print their names and sign the form.
Additionally, it humorously offers options for support such as dispatching a "hugger" or providing a "blankey", a "binky", and/or a bottle upon request.

Is the Hurt Feelings Report form official?

No, the Hurt Feelings Report form is not an official document recognized by any military or governmental organization. It is a satirical tool meant to humorously address complaints and grievances within military units, emphasizing resilience and toughness expected in military culture. It should not replace actual grievance or counseling procedures where real mental or emotional harm has occurred.

What are some examples of reasons for filing this report?

Examples of reasons provided on the form for filing a Hurt Feelings Report include statements that mock sensitivity and resilience, such as:

  • I am thin-skinned
  • I am a wimp
  • I have woman/man-like hormones
  • I am a crybaby
  • I want my mommy
  • My feelings are easily hurt
  • The weather is too cold
  • Two beers is not enough
These options are intended to be humorous and exaggerate complaints often heard in tough environments, emphasizing the satirical nature of the form.

How do leaders use the Hurt Feelings Report form?

Leaders, while understanding the form's humorous intent, might use it to lightly address complaints or grievances within their unit, promoting a culture of resilience and humor. It allows them to acknowledge the individual's feelings in a lighthearted manner, possibly opening a dialogue about resilience, stress management, and realistic expectations in a military context. However, for situations involving genuine mental or emotional distress, leaders are encouraged to use official channels and offer real support and resources.

Common mistakes

Submitting forms within any organization requires accuracy and attention to detail. However, individuals frequently make several common mistakes when completing the Hurt Feelings Report form. Recognizing and avoiding these errors can improve the efficacy of the documentation process and ensure the concerns are appropriately addressed.

  1. Incorrectly identifying the whiner's name and other administrative data. It’s crucial to provide accurate details in order for the form to be processed correctly. Incorrect or incomplete information in this section can result in delays or the inability to follow up on the report.
  2. Failing to precisely mark the date and time when feelings were hurt. This information is vital for tracking incidents and understanding the context of the situation. Detailing the exact timing can also help in identifying potential witnesses or patterns of behavior.
  3. Overlooking the importance of the narrative section. Many individuals provide vague descriptions of the incident. It’s essential to clearly and concisely describe the situation, as this can significantly affect the outcome and understanding of the incident.
  4. Misunderstanding the reason for filing the report section by not marking all applicable boxes or jokingly marking boxes not applicable to their situation. The purpose of this section is to indicate the nature of the hurt feelings, which helps in determining the appropriate response.
  5. Not properly obtaining or providing the necessary signatures for authentication. This oversight can question the legitimacy of the report. Both the individual reporting and the person responsible for the submission must sign the form to validate the report.

When filling out the Hurt Feelings Report, approaching each section with sincerity and attention to detail is crucial. Keeping these common mistakes in mind and ensuring they are avoided can help in conveying the necessary information effectively and obtaining the required support or resolution.

Documents used along the form

In modern workplace and military environments, documentation plays a crucial role not only in maintaining order but also in ensuring that all grievances and incidents are accounted for properly. While the Hurt Feelings Report form takes a satirical approach towards addressing complaints, it often accompanies or is complemented by other serious forms and documents that serve real, pragmatic purposes in ensuring a safe, respectful, and professional environment. Here is a list of other forms and documents that are frequently used together with the Hurt Feelings Report in various contexts.

  • Incident Report Form: This document is used to record the specifics of any unusual incidents that occur, especially those involving workplace safety or security concerns. It typically includes information about the time, location, individuals involved, and a detailed account of the event.
  • Employee Complaint Form: Utilized by employees to formally lodge complaints related to the workplace. This could range from issues with colleagues, to grievances about working conditions or practices. It helps in initiating a formal review process by the HR department.
  • Counseling Record Form: Following incidents or complaints, this document is filled out to record the details of counseling sessions provided to employees involved, including the reason for counseling, the outcome expected, and any follow-up actions.
  • Workplace Safety Evaluation Form: This is used to assess and record the safety measures and conditions of the workplace. It is a critical tool for identifying potential hazards and ensuring compliance with safety standards.
  • Feedback and Performance Review Form: A comprehensive document used for conducting regular performance evaluations of employees. It covers various metrics such as work efficiency, teamwork, leadership qualities, and goal attainment. Feedback provided can help in personal and professional development.
  • Equal Opportunity Complaint Form: Essential for reporting violations of equal opportunity policies within the organization. It facilitates the investigation of complaints related to discrimination or harassment, providing a pathway to address and resolve such issues.

The integration of these documents alongside the Hurt Feelings Report underscores the importance of a multi-faceted approach to dealing with personnel issues, complaints, and the overall well-being of individuals within an organization. While the Hurt Feelings Report may approach the subject with humor, the existence of these complementary forms highlights a comprehensive system aimed at addressing a wide range of serious concerns, fostering a supportive and respectful environment for all individuals involved.

Similar forms

  • Employee Performance Review Forms: These forms, utilized in many workplaces, share similarities with the Hurt Feelings Report in terms of structure, such as collecting administrative data about the employee and detailing specific incidents or behaviors. Both forms are designed to evaluate performance or conduct within a professional setting, albeit with very different purposes and tones.

  • Incident Report Forms: Incident report forms are used in various contexts, including workplaces, schools, and public spaces, to document any unusual or noteworthy events, especially those requiring further action or investigation. Like the Hurt Feelings Report, these forms typically include sections on when and where the incident occurred, the individuals involved, and a narrative description of the event.

  • Customer Complaint Forms: These forms allow customers to report dissatisfaction with a service or product. Similar to the Hurt Feelings Report, they often collect information on the complainant, details of the complaint, and the desired resolution. Both types of forms serve as formal mechanisms for voicing grievances, though the context differs significantly.

  • Mental Health Intake Forms: While serving a more serious and sensitive purpose, mental health intake forms bear structural resemblance to the Hurt Feelings Report by gathering personal information, assessing the individual's emotional state, and understanding specific concerns or incidents affecting their well-being. The tone and intent are vastly different, as mental health forms are designed with care and professionalism to support individuals seeking help.

Dos and Don'ts

When filling out the Hurt Feelings Report form, it is crucial to approach the task with a balance of seriousness and attention to detail. Below are lists of things you should and shouldn't do, to ensure the process is handled correctly.

Do:

  1. Provide accurate and complete information in all sections of the form, including administrative data and the incident report.
  2. Mark the appropriate boxes with care, particularly in the Injury and Reason for Filing sections, to accurately reflect the situation.
  3. Use respectful and professional language in the narrative section, detailing the incident clearly and concisely.
  4. Ensure that both the person filling out the form and the whiner (if applicable) sign and date the form to authenticate the information provided.
  5. Review the form before submission to check for any errors or omitted information.
  6. Remember the principal purpose of the form is to aid in documenting feelings for further action, so take it seriously.

Don't:

  1. Leave any fields blank. If a section does not apply, indicate this with an appropriate response.
  2. Exaggerate or fabricate details in the narrative or anywhere else on the form, as this could lead to misinformation.
  3. Use offensive or inappropriate language, keeping in mind the form's professional and constructive intent.
  4. Ignore the guidelines for marking checkboxes accurately, as this could misrepresent the incident.
  5. Forget to provide the necessary signatures, as unsigned forms may not be processed.
  6. Overlook the opportunity to request additional support if needed, as indicated in the form's closing note.

Misconceptions

The "Hurt Feelings Report" form, often mentioned in various professional settings, particularly within the military, has been surrounded with misconceptions. It's vital to understand the misconceptions surrounding this document to approach sensitive situations with the appropriate level of seriousness and respect.

  • It's an official document: Contrary to what some might believe, the Hurt Feelings Report is not an official document approved by any branch of the military or any other organization. It is a satirical form that makes light of reporting hurt feelings in a professional environment.

  • It's designed to address genuine concerns: The purpose of the Hurt Feelings Report is often misunderstood. It's not intended to tackle real emotional or psychological issues. Instead, it parodies the process of reporting grievances by trivializing emotional distress, which can be harmful and dismissive to those genuinely affected.

  • Disclosure of personal information is required: The form requests personal information, like Social Security numbers and detailed incident reports, which can be mistakenly taken as a requirement. In reality, sharing such sensitive information in this context would be inappropriate, considering the form’s unofficial and satirical nature.

  • It promotes a supportive work environment: One might think the Hurt Feelings Report encourages a culture of understanding and support within the workplace. This is misleading. Rather than fostering a positive environment, its use can belittle legitimate complaints, potentially creating a workplace that discourages open and honest communication about issues.

  • It's beneficial for leadership and counseling: While the form jokingly mentions assisting leaders with a list of individuals who need "additional counseling, NCO leadership, and extra duty," it is not a useful tool for leadership or professional development. Effective leadership involves genuine empathy and understanding, not the mockery of emotional responses.

In sum, the Hurt Feelings Report serves as a reminder that sensitivity should be exercised in professional environments, recognizing genuine concerns and emotional well-being rather than making light of them. Understanding and empathy are key in fostering a supportive and productive workplace.

Key takeaways

Understanding the Hurt Feelings Report form can provide valuable insights into the organizational approach towards addressing personal grievances and emotional well-being in a structured manner. Here are five key takeaways to consider when looking at this document:

  • The Hurt Feelings Report form serves a dual purpose: it's a tool for documenting instances where an individual's feelings were hurt, and it also identifies those who might need additional support through counseling or leadership efforts.
  • Details required in the form, such as the whiner’s name, the date and location of the incident, and specifics about the injury (e.g., whether there was permanent emotional damage or if a tissue was needed for tears), emphasize the form's role in taking every claim seriously, despite the tongue-in-cheek tone of the form.
  • Voluntary disclosure is encouraged through the form; however, it highlights that repeated disclosures may lead to more intensive counseling sessions, as indicated by the possible outcome of receiving a DA Form 779-1A for wall-to-wall counseling.
  • The form accommodates a broad spectrum of reasons for filing a report, including feeling thin-skinned, wanting maternal comfort, or dissatisfaction with environmental conditions. This breadth underscores an acknowledgment of diverse triggers for emotional distress, albeit in a humorous manner.
  • The commitment to provide immediate support to individuals with hurt feelings, through the promise of dispatching a "hugger" or even fire personnel in the absence of a hugger, along with the offer of additional comfort items like a "blankey" or a "binky," showcases an exaggerated but underlying commitment to employee or member welfare.

Despite its satirical nature, the Hurt Feelings Report underscores the importance of addressing emotional distress and the need for supportive measures in organizational settings, albeit in a manner that might not be appropriate in all contexts.

Please rate Hurt Feelings Report Template Form
5
(Exceptional)
2 Votes

Create More Documents