TEST MOD BUTTHURT REPORT FORM
Provided as a public service by the Night Crew
WHO CAUSED YOU TO BE TRIGGERD? *
DATE AND TIME THAT YOU EXPERIENCED BUTTHURT *
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Time
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PLEASE DESCRIBE THE NATURE OF THE BUTTHURT *
Required
ON A SCALE OF 1 TO 10 HOW BAD DOES YOU BUTT FEEL? *
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PLEASE TELL US MORE ABOUT THE INCIDENT OF BUTTHURT *
Required
Were there tears? *
Was there permanent mental scarring from the butthurt? *
Was there lost sleep from the butthurt? *
Did you miss work or arrive late to work because of the butthurt? *
Were you forced to employ a Coping Mechanism, such as uninstalling life.exe, alcohol consumption, or breaking your phone? *
Was the internet police involved? *
Was there any incident of Carpal Tunnel Syndrome resulting from you typing up long-ass Butthurt Rebuttals? *
PLEASE TELL US MORE ABOUT THE PERSON WHO CAUSED THE BUTTHURT *
Required
DID YOU TAKE ANY ACTIONS YOURSELF REGARDING THE BUTTHURT? *
Required
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