What I need to communicate

Write the situation in one or two factual sentences. What needs to be understood?

What I am afraid may happen

Name the fear without treating it as a fact. What response are you anticipating?

What I actually want to request

Turn the complaint into one request that another person can answer.

My clear wording

Use: “When… I feel/experience… I need… Would you be willing to…?”

The tone I want to keep

Choose a pace, volume, and opening that leaves room for a different answer.

What I will not do

Write the behavior you will avoid, such as insulting, threatening, interrupting, or apologizing for having a limit.

Possible responses

If they agree, disagree, or need time, how will you remain clear and respectful?

My follow-through

What will you do if the request is not possible or the boundary is crossed?

A practical next step

If you want to clarify how this applies to your situation, you can begin with a Zero Session.