Date of Hurtlulness: Time:
What caused the butthurt?
 Someone posted it E] Offensive picture on the internet
Was a tissue needed for lhe tears?
DYes I:] No
Will you be able to move past it?
E] Yes I:] No C] Not sure
Reason for filing the Report (check all that apply):
I:] I am an idiot. [3 I'm better than everyone else,
D I am thinvskinned  It wasn't my joke.
(Use a separate sheet if necessary)