To: All Army Supervisors
From: The Secretary of the Army
Subject: Hurt Feelings Report
Cc: All Departments Heads, All Department Managers

Please review the following addition to the Supervisor's Handbook:

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 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 Feelings

F. Rank/Grade

G. Organization(If different from 1E above)

A. Which Ear Were the Words of Hurtfulness Spoken Into?
Spacer Spacer Left Spacer Right Spacer Both
B. Is There Permanent Feeling Damage?
Spacer Spacer Yes Spacer No Spacer Maybe
C. Did You Require a "Tissue" for Tears?
Spacer Spacer Yes Spacer No Spacer Multiple Spacer Spacer How Many?
D. Has This Resulted in a Traumatic Brain Injury?
Spacer Spacer Yes Spacer No Spacer Maybe
Reason for Filing This Report (Mark all that apply)
Spacer I am thin skinned. Spacer The Army needs to fix my problems. Spacer Two beers is not enough.
Spacer I am a whimp. Spacer My feelings are easily hurt. Spacer My hands should be in my pockets.
Spacer I have woman/man-like hormones. Spacer I didn't sign up for this. Spacer I was not offered a post-grief debriefing.
Spacer I am a crybaby. Spacer I was told that I am not a hero. Spacer Someone requested a post-grief debriefing.
Spacer I want my Mommy. Spacer The weather is too cold. Spacer All of the above, and more.
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 W#1, April 2009 Edition of April, 1989 is Obsolete

Valid CSS! Spacer Valid HTML 5!