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Report Offensive Material

HURT  FEELINGS  REPORT

Fill out this Form to report any offensive material that hurt your feelings.

  1. WHAT WAS THE DATE AND TIME
    WHEN YOUR FEELINGS WERE HURT ?


  2. WHAT DID THE FUNNY DESIGN SAY
    (or show) THAT WAS OFFENSIVE ?


  3. WAS THE DESIGN or WORDS SHOUTING
    AT YOU   (as in all CAPS) ?


  4. DID IT HURT YOUR EYES
    OR JUST YOUR FEELINGS ?


  5. NEED A HUG ?    

  6. WHEN DID YOU REALIZE YOU WERE
    NOT A REAL MAN (or WOMAN) ?


  7. WERE YOU WEARING PERSONAL PROTECTION EQUIPMENT (PPE) ?


  8. DID ANYONE ELSE NEAR YOU HAVE
    THEIR FEELINGS HURT TOO ?


  9. USING CRAYONS, DRAW A DESIGN THAT
    MAKES YOU FEEL BETTER AND HAPPIER.
We'll analyze it to see if you need a pair.


Your Name: 
Your Email: 

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