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
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…
For subordinate leader development IAW FM 22-102. Leaders and 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
PART ONE — ADMINISTRATIVE DATA
Whiner’s Name: (Last, First, MI)
Date of Report:
Name and Title of the Person Filling Out This Form:
PART TWO — INCIDENT REPORT
Date Feelings Were Hurt:
Time of Hurtfulness:
Location of Hurtful Incident:
NCO or Officer Sympathetic to Whiner:
Name of Real Man/Woman Who Hurt Your Sensitive Feelings:
Organization (If different from above) :
INJURY (Mark All That Apply)
Which Ear Were the Words of Hurtfulness Spoken Into?
Is There Permanent Feeling Damage?
Did You Require A “Tissue” For Tears?
Has This Resulted In a Traumatic Brain Injury?
I am thin-skinned
I am a wimp
I have woman/man-like hormones
I am a crybaby
I want my mommy
The Army need 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 too cold
Two beers are 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
NARRATIVE (Tell us in your own sissy words how your feelings were hurt.)
PART THREE — AUTHENICATION
Printed Name of Real Man/Woman:
Printed Name of Whiner:
We, as the Army, take hurt feelings very 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, MAY 2009
EDITION OF APRIL 1989 IS OBSELETE