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Hurt Feelings Report

Nov 18, 2014

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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. Disclosure

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

PARTIADMINISTRATIVEDATAA.WHINERSNAME(Last,First,MI) B. POSITION

C.DATEOFREPORT

D.ORGANIZATION

E.NAME&TITLEOFTHEPERSONFILLINGOUTTHISFORM

PARTIIINCIDENTREPORTA.DATEFEELINGSWEREHURT B.TIMEOFHURTFULNESS C.LOCATIONOFHURTFULINCIDENT F. POSITION D.PERSONSYMPATHETICTOWHINER G.ORGANIZATION(ifdifferentfrom 1d above)

E.NAMEOFREALMAN/WOMANWHOHURTYOURSENSITIVE FEELINGS

A.WHICHEARWERETHEWORDSOFHURTFULNESSSPOKENINTO?

PART III -INJURY(Markallthatapply)

LEFTRIGHTBOTH

B.ISTHEREPERMANENTFEELINGDAMAGE?

YESNOMAYBE YESNOMAYBE

C.DIDYOUREQUIREATISSUEFORTEARS?

YESNOMULTIPLE________

D.HASTHISRESULTEDINATRAUMATICBRAININJURY?

Iamthinskinned Iamawimp Ihavewoman-likehormones Iamacrybaby Iwantmymommy

PART IV -REASONFORFILINGTHISREPORT(Markallthatapply) Someone needstofixmyproblems The weather is too cold Myfeelingsareeasilyhurt The weather is too hot You wouldn't understand The weather is to dry IwastoldthatIamnotspecial The weather is too rainy Two beers is not enough All of the above and more

PART V -NARRATIVE(Tellusinyourownsissywordshowyourfeelingswerehurt.)

A.PRINTEDNAMEOFREALMAN/WOMAN

B.SIGNATURE

PARTVIAUTHENTICATION

C.PRINTEDNAME OFWHINER

D.SIGNATURE

Wetakehurtfeelingsseriously.Ifyoudon'thavesomeonewhocangiveyouahugandmakethingsallbetter,pleaseletusknowandwe willpromptlydispatcha"hugger"toyouASAP.Intheeventweareunabletofinda"hugger"wewillnotifythefiredepartmentandrequestthatthey sendfirepersonneltoyourlocation.Ifyouareinneedofsupplementalsupport,uponwrittenrequest,wewillmakeeveryreasonableefforttoprovide youwitha"blankey",a"binky"and/orabottleifyousodesire. WUSSFORMHFR,APRIL2009EDITIONOFAPRIL1989ISOBSELETE