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Get Injury To Feelings Template

PART I ADMINISTRATIVE DATA A. Whiner s Name Last First MI B. Position E. Branch/Dept. C. SSAN D. Date of this Report F. Name Title of Person Completing this Form PART II INCIDENT REPORT A. Date feelings were hurt B. Time of hurtfulness E. Name of person who hurt your feelings C. Location of hurtful incident F. Position if banker D. HURT FEELINGS REPORT Data Required by the Privacy Act of 1974 AUTHORITY 12 CFR 216 Bank Policy CP-Privacy KNOT Board Directive AZ-50 PRINCIPAL PURPOSE To assist whiners in documenting hurt feelings and to provide managers with a list of employees who require counseling weekend/holiday shifts and other duties as assigned. ROUTINE USES Branch Mgrs Compliance BSA Security and Audit Officers whiners should complete this form as necessary including in response to audit reports being shot down in meetings etc. DISCLOSURE Disclosure is voluntary but repeated disclosures indicate an employee eligible for promotion at another bank. Has this resulted in a traumatic emotional injury PART IV REASON FOR FILING THIS REPORT Mark all that apply I am thin skinned The bank needs to fix all my problems I was only texting on the clock My feelings are hurt easily Balancing is hard This wasn t mentioned at indoctrination Someone stole my lunch We ve always done it that way But it wasn t in the last audit report Internal audit external audit when am I supposed to do my job Porn filter interference No one said I couldn t It wasn t my fault It is personal not business My computer is old But I really was tired PART V NARRATIVE Tell us in your own words why your poor ittle bittle feelings were hurt. PART I ADMINISTRATIVE DATA A. Whiner s Name Last First MI B. Position E* Branch/Dept. C. SSAN D. Date of this Report F* Name Title of Person Completing this Form PART II INCIDENT REPORT A. Date feelings were hurt B. Time of hurtfulness E* Name of person who hurt your feelings C. Location of hurtful incident F* Position if banker D. Mgr sympathetic to whiner PART III INJURY Mark all that apply A. How was the hurtfulness communicated B. Is there permanent damage to your feelings Oral Yes No Maybe Written Both C. Did you require a tissue D. That is enough. PART VI AUTHENTICATION A. Name of Whiner Printed B. Signature This Bank takes hurt feeling seriously. If you were mentioned in an audit or treated in a derogatory manner by anyone please find someone to give you a hug and things will be better. In the event no hugger is available Human Resources will seek to find someone for you who really will care. We are sorry for your inconvenience but yes you still have to work tomorrow and yes the audit response or apology to the customer must still be made. Date feelings were hurt B. Time of hurtfulness E* Name of person who hurt your feelings C. Location of hurtful incident F* Position if banker D. Mgr sympathetic to whiner PART III INJURY Mark all that apply A. How was the hurtfulness communicated B. Mgr sympathetic to whiner PART III INJURY Mark all that apply A. How was the hurtfulness communicated B. Is there permanent damage to your feelings Oral Yes No Maybe Written Both C. Did you require a tissue D. .

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