Edit, Download, and Sign the Hurt Feelings Report Form - Army Counseling
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How do I fill this out?
To fill out this form, start by entering your personal details in Part I. Next, provide specifics of the incident in Part II including individuals involved. Finally, complete the authentication section before submission.

How to fill out the Hurt Feelings Report Form - Army Counseling?
1
Enter your personal information in Part I.
2
Detail the incident that caused hurt feelings in Part II.
3
Identify witnesses or sympathizers if applicable.
4
Provide a narrative of the incident in your own words.
5
Sign and date the form for authentication.
Who needs the Hurt Feelings Report Form - Army Counseling?
1
Soldiers experiencing emotional distress due to incidents.
2
Leaders seeking to document and address soldiers' concerns.
3
Counselors looking for official reports to refer to.
4
HR personnel managing soldier welfare and support.
5
Individuals filing for emotional support assistance.
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What are the instructions for submitting this form?
To submit the Hurt Feelings Report, please ensure that all fields are thoroughly completed and signed. You may send the completed form via email to the designated counseling office or deliver it in person at your unit’s support office. For fax submissions, use the provided fax number located on the form itself. It is advisable to keep a copy of the submitted report for your records.
What are the important dates for this form in 2024 and 2025?
Currently, there are no significant upcoming dates specific to the Hurt Feelings Report. It is advisable to review any regulatory updates or directive revisions in 2024 and 2025.

What is the purpose of this form?
The purpose of the Hurt Feelings Report Form is to formally document instances of emotional distress within the Army ranks. This form assists leaders in recognizing soldiers who may need additional support or counseling. By utilizing this report, the Army can ensure that emotional well-being is prioritized and addressed effectively.

Tell me about this form and its components and fields line-by-line.

- 1. Whiner's Name: Full name of the individual documenting the hurt feelings.
- 2. Rank/Grade: Military rank or grade of the individual.
- 3. Social Security Number: SSN for official documentation purposes.
- 4. Date of Report: The date when the report is filled out.
- 5. Organization: The organizational affiliation of the individual filling the form.
- 6. Incident Details: Specifics of the emotional incident including time and location.
- 7. Narrative: A detailed account of how feelings were hurt.
- 8. Signatures: Required signatures for authentication.
What happens if I fail to submit this form?
Failure to submit this form could lead to a lack of support for emotional concerns, leaving issues unresolved. Such situations may hinder leadership's ability to address the emotional welfare of soldiers effectively. It is crucial to prioritize emotional documentation to foster a supportive environment.
- Unresolved Emotional Issues: Without submission, feelings of distress may not be addressed.
- Lack of Leadership Awareness: Leaders may not be aware of the emotional struggles within their units.
- Increased Emotional Distress: Soldiers may experience heightened distress without formal recognition.
How do I know when to use this form?

- 1. Emotional Disputes: When disagreements lead to hurt feelings among soldiers.
- 2. Conflict Situations: In events where interaction with others has caused emotional distress.
- 3. Feedback and Counseling: As part of feedback during counseling sessions regarding soldier’s emotions.
Frequently Asked Questions
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What information do I need to fill out?
You will need to provide personal details, specifics about the incident, and your narrative.
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Can I use this form for any incident?
This form is specifically meant for documenting hurt feelings in a military context.
How do I submit the form once completed?
Follow the submission instructions provided with the form on PrintFriendly.
What's the main purpose of this form?
To assist soldiers in documenting emotional distress and to provide leadership with necessary information.
Who can access this form?
Any soldier or leader needing to document emotional concerns can access and use this form.