hurt feelings report
DESCRIPTION
HURT FEELINGS REPORT For use of this form, see WM b00-h00; the proponent agency is WUSS AUTHORITY: PRINCIPAL PURPOSE: ROUTINE USES: DISCLOSURE: DATA REQUIRED BY THE PRIVACY ACT OF 1974 Whiner Understanding and Support Service To assist whiners in documenting hurt feelings, and to provide managers with a list of personnell who require additional counseling, support and extra duty For subordinate leader development IAW WM 22-102. Supervisors & whiners should use this form as necessary. DisclosureTRANSCRIPT
HURT FEELINGS REPORT
DATA REQUIRED BY THE PRIVACY ACT OF 1974
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
PART II – INCIDENT REPORT
FEELINGS
LEFT RIGHT BOTH YES NO MAYBE
YES NO MULTIPLE ________ YES NO MAYBE
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.
A. WHINER’S NAME (Last, First, MI) B. POSITION C. DATE OF REPORT
D. ORGANIZATION E. NAME & TITLE OF THE PERSON FILLING OUT THIS FORM
A. DATE FEELINGS WERE HURT B. TIME OF HURTFULNESS C. LOCATION OF HURTFUL INCIDENT D. PERSON SYMPATHETIC TO WHINER
E. NAME OF REAL MAN/WOMAN WHO HURT YOUR SENSITIVE F. POSITION G. ORGANIZATION (if different from 1d above)
PART III - INJURY (Mark all that apply)
PART IV - REASON FOR FILING THIS REPORT (Mark all that apply)
I am a wimp My feelings are easily hurt The weather is too hot
I am thin skinned Someone needs to fix my problems The weather is too cold
PART V - NARRATIVE (Tell us in your own sissy words how your feelings were hurt.)
PRINCIPAL PURPOSE: To assist whiners in documenting hurt feelings, and to provide managers with a list of personnell who require additional counseling,
PART VI ‐ AUTHENTICATION
I want my mommy Two beers is not enough All of the above and more
We 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
A. WHICH EAR WERE THE WORDS OF HURTFULNESS SPOKEN INTO? B. IS THERE PERMANENT FEELING DAMAGE?
C. DID YOU REQUIRE A “TISSUE” FOR TEARS? D. HAS THIS RESULTED IN A TRAUMATIC BRAIN INJURY?
support and extra duty
AUTHORITY: Whiner Understanding and Support Service
For use of this form, see WM b00-h00; the proponent agency is WUSS
WUSS FORM HFR, APRIL 2009 EDITION OF APRIL 1989 IS OBSELETE
ROUTINE USES: For subordinate leader development IAW WM 22-102. Supervisors & whiners should use this form as necessary.
I am a crybaby I was told that I am not special The weather is too rainy
I have woman-like hormones You wouldn't understand The weather is to dry
A. PRINTED NAME OF REAL MAN/WOMAN B. SIGNATURE C. PRINTED NAME OF WHINER D. SIGNATURE