ORDER
EILEEN S. WILLETT, Magistrate Judge.
Pending before the Court are a number of motions filed by Plaintiff. The Court has reviewed the Motions and issues its rulings as set forth below.
I. DISCUSSION
A. Plaintiff's "Motion to Amend Complaint" (Doc. 46)
In January 2016, Plaintiff moved to amend his complaint to name additional defendants. (Doc. 34). Plaintiff lodged a proposed First Amended Complaint, but did not comply with Rule 15.1 of the Local Rules of Civil Procedure ("LRCiv") by indicating in what respect it differs from the original Complaint (i.e. by bracketing or striking through the text to be deleted and underlining the text to be added). The First Amended Complaint also contained illegible text in violation of LRCiv 5.4. The Court denied Plaintiff's Motion (Doc. 34) for failure to comply with Local Rules of Civil Procedure and extended the deadline for filing a second motion to amend to March 24, 2016. (Doc. 44).
On March 25, 2016, the Clerk of Court docketed Plaintiff's "Motion to Amend Complaint." Although the Motion does not contain a certificate of service indicating when Plaintiff mailed it to the Court,1 because the Motion was docketed on March 25, 2016, the Court presumes it was mailed on March 24, 2016 at the latest. The Court deems the Motion timely filed.
1. Plaintiff has Complied with LRCiv 15.1
Defendants argue that Plaintiff's Motion to Amend (Doc. 46) fails to comply with LRCiv 15.1, resulting in confusion as to what comprises Plaintiff's proposed First Amended Complaint. (Doc. 48 at 3). The Court finds that Defendants' argument rests on a misconstruction of Plaintiff's Motion. Plaintiff's Motion explains that the original Complaint is attached as an exhibit and that Plaintiff has bracketed the language that is to be deleted and replaced with the underlined text set forth in Pages 3-5 of the Motion.2 For instance, regarding Defendant Pratt's place of employment in Section B of the Complaint, Plaintiff bracketed "Corizon":
B. Defendants
1. Name of first Defendant: Charlse [sic] Ryan. The first Defendant is employed as: ADOC Director at ADOC (Position and Title) (Institution)
2. Name of first Defendant: Richard Pratt. The first Defendant is employed as: A Director at [Corizon]. (Position and Title) (Institution)
3. Name of first Defendant: ____________. The first Defendant is employed as:____________________ at ____________________. (Position and Title) (Institution)
4. Name of first Defendant: ________________. The first Defendant is employed as: ___________________________ at ______________________. (Position and Title) (Institution)
(Doc. 46 at 8).
On Page 3 of the Motion, Plaintiff identifies by underlined text the language to be added to Section B of the Complaint. As shown below, Plaintiff has indicated that "ADOC" is to be listed as the institution at which Defendant Pratt is employed (instead of "Corizon"). Plaintiff has also identified by underlined text the additional defendants to be included in Section B of the Complaint:
B. Defendants
2. (Institution), (ADOC)
3. N. Maranzo, (NP) at Corizon
4. Steve Ibrahim, D.O. at Corizon
additional Defendants:
Stueward, (MD) at Corizon
Craig Kevis, Provider at Mountain Vista Medical Center
Okafor, Joachin U, (MD) at Mountain Vista Medical Center
(Doc. 46 at 3).
Regarding Count One of the Complaint, Plaintiff has indicated by the use of brackets and underlined text that he wishes to delete "14th Amendment" in the field pertaining to the right alleged to be violated and replace it with "8th Amendment." (Doc. 46 at 4, 9). By using brackets, Plaintiff has also indicated that he wishes to delete all of the handwritten text in the "Supporting Facts" and "Injury" sections and replace it with the underlined text set forth on Page 4 of the Motion. (Id.).
Plaintiff has bracketed all of the handwritten text in Count Two of the Complaint (Doc. 46 at 10), but has not proposed any replacement text. The proposed First Amended Complaint essentially consolidates Counts One and Two, which is consistent with the Court's October 2015 Order. That Order indicated that Count One was improperly brought as a Fourteenth Amendment claim. However, instead of dismissing Count One, the Court considered Counts One and Two as a single claim for violations of Plaintiff's Eighth Amendment rights because Count One contained most of Plaintiff's factual allegations. (Doc. 26 at 3 n.1).
Finally, Plaintiff has bracketed all of the handwritten text contained in the "Request for Relief" section (Doc. 46 at 12) and has underlined the replacement text (Doc. 46 at 5).
While Plaintiff has not attached a traditional "redline" of the Complaint showing his proposed changes, the Court finds that Plaintiff has complied with LRCiv 15.1 by "bracketing or striking through the text to be deleted and underlining the text to be added." The Court further finds that Plaintiff has adequately explained how the First Amended Complaint differs from the original Complaint.
2. Leave to File a First Amended Complaint will be Granted
Rule 15(a) of the Federal Rules of Procedure provides that "leave [to amend a pleading] shall be freely given when justice so requires." A district court has the discretion to grant or deny a motion to amend. See, e.g., Ventress v. Japan Airlines, 603 F.3d 676, 680 (9th Cir. 2010); Chappel v. Laboratory Corp. of Amer., 232 F.3d 719, 725 (9th Cir. 2000). Although Rule 15(a) is very liberal, courts "need not grant leave to amend where the amendment: (1) prejudices the opposing party; (2) is sought in bad faith; (3) produces an undue delay in the litigation; or (4) is futile." AmerisourceBergen Corp. v. Dialysis West, Inc., 465 F.3d 946, 951 (9th Cir. 2006). These factors, however, are not given equal weight. "Futility of amendment can, by itself, justify the denial of a motion for leave to amend." Bonin v. Calderon, 59 F.3d 815, 845 (9th Cir. 1995); see also Lockheed Martin Corp. v. Network Solutions, Inc., 194 F.3d 980, 986 (9th Cir. 1999) ("Where the legal basis for a cause of action is tenuous, futility supports the refusal to grant leave to amend.").
Defendants argue that Plaintiff's Motion should be denied on the basis that the proposed First Amended Complaint is futile. (Doc. 48 at 4). "A proposed amended complaint is futile if it would be immediately subject to dismissal." Nordyke v. King, 644 F.3d 776, 788 n. 12 (9th Cir. 2011) (citation and internal quotation marks omitted), aff'd on reh'g en banc on other grounds, 681 F.3d 1041 (9th Cir. 2012); see also Miller v. Rykoff-Sexton, Inc., 845 F.2d 209, 214 (9th Cir. 1988) (citing authority explaining that the "proper test to be applied when determining the legal sufficiency of a proposed amendment is identical to the one used when considering the sufficiency of a pleading challenged under Rule 12(b)(6)").
As explained below, the Court does not find that Plaintiff's proposed First Amended Complaint fails to state a claim. Although the Court denied Plaintiff's Motion for Preliminary Injunction based on the evidence submitted, a proposed amended complaint is futile "only if no set of facts can be proved under the amendment to the pleadings that would constitute a valid and sufficient claim or defense." Miller, 845 F.2d at 214. "Merely because Plaintiff[] possessed insufficient evidence at the time of the preliminary injunction hearing to show a likelihood of success on the merits of all of [his] claims does not mean the evidence does not exist and cannot be obtained through discovery. Therefore, amendment is not futile." Nat'l City Bank, N.A. v. Prime Lending, Inc., No. CV-10-034-EFS, 2010 WL 2854247 at *9 (July 19, 2010); see also Nordyke, 644 F.3d at 788 n.12 ("In evaluating whether the district court should have granted the Nordykes' motion for leave to amend . . . we look only to facts pled in the Proposed Second Amended Complaint."). The Court will grant Plaintiff's "Motion to Amend Complaint" (Doc. 46) and will direct Plaintiff to file a "clean" version of the First Amended Complaint.
3. Plaintiff's Proposed First Amended Complaint States an Eighth Amendment Claim
i. Continuing Obligation to Screen
The Court has a continuing obligation to screen complaints brought by prisoners seeking relief against an officer or employee of a governmental entity. 28 U.S.C. § 1915A(a). The screening requirement extends to proposed amended complaints as well as complaints initially filed in an action. The Prison Litigation Reform Act, 42 U.S.C. § 1997e(c)(1), requires the Court to dismiss all allegations that fail to state a claim upon which relief may be granted. See O'Neal v. Price, 531 F.3d 1146, 1153 (9,th Cir. 2008). The Court must dismiss a complaint or portion thereof that is legally frivolous, fails to state a claim upon which relief may be granted, or seeks monetary relief from a defendant who is immune from suit. 28 U.S.C. § 1915(A)(b)(1), (2).
In reviewing Plaintiff's proposed First Amended Complaint, the Court must accept as true all well-pled factual allegations and draw all reasonable inferences therefrom. See Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007); Steckman v. Hart Brewing, Inc., 143 F.3d 1293, 1296-98 (9th Cir. 1998). A claim for relief must be plausible on its face to survive a motion to dismiss. Ashcroft v. Iqbal, 556 U.S. 662, 663 (2009). "A claim has facial plausibility when the plaintiff pleads factual content that allows the Court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. at 679.
Finally, a first amended complaint supersedes the original complaint. See Ferdik v. Bonzelet, 963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v. Richard Feiner & Co., 896 F.2d 1542, 1546 (9th Cir. 1990). After amendment, the Court will treat an original complaint as nonexistent. Ferdik, 963 F.2d at 1262 ("after amendment the original pleading no longer performs any function and is treated thereafter as non-existent") (internal quotation marks and citation omitted). Any cause of action that was raised in the original complaint and that was voluntarily dismissed or was dismissed without prejudice is waived if it is not alleged in a proposed amended complaint. Lacey v. Maricopa County, 693 F.3d 896, 928 (9th Cir. 2012) (en banc).
ii. Eighth Amendment Medical Claims
Not every claim by a prisoner relating to inadequate medical treatment states a violation of the Eighth or Fourteenth Amendment. To state a Section 1983 medical claim, a plaintiff must show (i) a "serious medical need" by demonstrating that failure to treat the condition could result in further significant injury or the unnecessary and wanton infliction of pain and (ii) the defendant's response was deliberately indifferent. Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006).
"Deliberate indifference is a high legal standard." Toguchi v. Chung, 391 F.3d 1051, 1060 (9th Cir. 2004). To act with deliberate indifference, a prison official must both know of and disregard an excessive risk to inmate health; "the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference." Farmer v. Brennan, 511 U.S. 825, 837 (1994). Deliberate indifference in the medical context may be shown by a purposeful act or failure to respond to a prisoner's pain or possible medical need and harm caused by the indifference. Jett, 439 F.3d at 1096. Deliberate indifference may also be shown when a prison official intentionally denies, delays, or interferes with medical treatment or by the way prison doctors respond to the prisoner's medical needs. Estelle v. Gamble, 429 U.S. 97, 104-05 (1976); Jett, 439 F.3d at 1096.
Deliberate indifference is a higher standard than negligence or lack of ordinary due care for the prisoner's safety. Farmer, 511 U.S. at 835. "Neither negligence nor gross negligence will constitute deliberate indifference." Clement v. California Dep't of Corr., 220 F.Supp.2d 1098, 1105 (N.D. Cal. 2002); see also Broughton v. Cutter Labs., 622 F.2d 458, 460 (9th Cir. 1980) (mere claims of "indifference," "negligence," or "medical malpractice" do not support a claim under § 1983). "A difference of opinion does not amount to deliberate indifference to [a plaintiff's] serious medical needs." Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989). A mere delay in medical care, without more, is insufficient to state a claim against prison officials for deliberate indifference. See Shapley v. Nevada Bd. of State Prison Comm'rs, 766 F.2d 404, 407 (9th Cir. 1985). The indifference must be substantial. The action must rise to a level of "unnecessary and wanton infliction of pain." Estelle, 429 U.S. at 105.
iii. Analysis
Plaintiff's factual allegations supporting his Eighth Amendment claim in the proposed First Amended Complaint are nearly identical to those alleged in the original Complaint (Doc. 1). Plaintiff asserts that he was diagnosed with "HIV-Immunodeficiency Virus in 2008 in Durango Jail-Juvenile Referral with multiple positive testings . . . ." (Doc. 46 at 4). Plaintiff alleges that Defendants have violated his Eighth Amendment rights by refusing to provide him with treatment for HIV/AIDS. (Id.). Further, Plaintiff states that on June 10, 2014 and December 17, 2014, he used "Administration Remedies" to petition Defendant Ryan and Pratt to seek treatment for AIDS, but they "refused to act nor consider my truth that I am dying from (AIDS) . . . ." (Id.). Plaintiff also alleges that the proposed additional defendants, who Plaintiff asserts are medical providers, "disbelieve my truth of dying or suffering from (AIDs)" and have deprived Plaintiff the appropriate medication. (Id.).
Liberally construing the original Complaint, the Court found that Plaintiff stated an Eighth Amendment medical claim against Defendants Ryan and Pratt. Applying that same liberal construction to the proposed First Amended Complaint, Plaintiff's allegations adequately state an Eighth Amendment medical claim against Defendants. The Court will require Defendants Ryan, Pratt, Maranzana, Ibrahim, Kevis, Okafor, and Stueward to answer the First Amended Complaint.
B. Plaintiff's "Recommendation to be Appointed Counsel" (Doc. 49)
In March 2016, the Court denied Plaintiff's request for the appointment of counsel (Doc. 36). (Doc. 44). On April 15, 2016, Plaintiff filed a "Recommendation to be Appointed Counsel" (Doc. 49), which Plaintiff states that "I believe the District Court is fully aware of my ignorance of law; I respectfully request to be Appointed Counsel . . . ."
As previously explained to Plaintiff, there is no constitutional right to the appointment of counsel in a civil case. See Johnson v. U.S. Dep't of Treasury, 939 F.2d 820, 824 (9th Cir. 1991); Ivey v. Bd of Regents of the Univ. of Alaska, 673 F.2d 266, 269 (9th Cir. 1982). The Court may appoint counsel for indigent civil litigants only in exceptional circumstances. Wilborn v. Escalderon, 789 F.2d 1328, 1331 (9th Cir. 1986)). The Court's March 10, 2016 Order did not find that exceptional circumstances existed in this case that warranted the appointment of counsel. (Doc. 44 at 2-3). Plaintiff's statements in his "Recommendation to be Appointed Counsel" (Doc. 49) do not alter that finding. Accordingly, the Court will deny Plaintiff's request for court-appointed counsel.
C. Plaintiff's "Discovery Request to be Examined by an Outside Physican [sic]" (Doc. 50)
Rule 35(a)(1) of the Federal Rules of Civil Procedure authorizes the Court to order a party whose mental or physical condition "is in controversy to submit to a physical or mental examination by a suitably licensed or certified examiner." Such an examination is justified if Plaintiff's medical condition is in controversy and good cause exists. Schlagenhauf v. Holder, 379 U.S. 104, 119-20 (1964).
On April 27, 2016, Plaintiff filed a "Discovery Request to be Examined by an Outside Physician" (Doc. 50). Plaintiff requests to be examined by a physician who "has no ties to" the Arizona Department of Corrections, Mountain Vista Hospital, or Corizon Health with respect to "the dispute of [his] current condition, for Immunodeficiency symptoms." (Doc. 50 at 2). Defendants construe Plaintiff's request as a "motion for some unspecified level of examination and/or care, by medical providers other than those he has seen . . . ." (Doc. 54 at 1). However, Plaintiff indicates in his filing that the request is being made to "procure[] discoverabl[e] information, that I can use to support my claim." (Doc. 50 at 2). To the extent Plaintiff's "Discovery Request" (Doc. 50) is a motion for an independent medical examination brought pursuant to Rule 35(a)(1) of the Federal Rules of Civil Procedure, Plaintiff has failed to set forth any reasons for the motion. Without a more detailed explanation, the Court cannot find good cause to grant Plaintiff's request. Plaintiff's "Discovery Request to be Examined by an Outside Physician" (Doc. 50) will be denied without prejudice.
D. Plaintiff's "Discovery Request to Subpoena Durango Jail-Juvenile Referral and Arizona Department of Corrections for Medical Records" (Doc. 51)
Plaintiff alleges that he was diagnosed with HIV/AIDS in 2008 while in custody at the Durango Jail. In his April 27, 2016 filing (Doc. 51), Plaintiff requests to subpoena his medical records from the Durango Jail and Arizona Department of Corrections. The Court will grant Plaintiff's "Discovery Request to Subpoena . . ." (Doc. 51) as to Plaintiff's medical records from Durango Jail-Juvenile. However, Plaintiff has already requested from Defendants Ryan and Pratt his medical records from the Arizona Department of Corrections. (Doc. 44 at 1-2). On April 11, 2016, Defendants Ryan and Pratt notified the Court that they have served their responses to Plaintiff's First Request for Production of Documents. (Doc. 47). If Plaintiff is asserting that the discovery responses are incomplete or inadequate, Plaintiff is directed to the section of the Court's Scheduling Order pertaining to discovery disputes. (Doc. 31 at 4). The Court will deny Plaintiff's "Discovery Request to Subpoena . . ." (Doc. 51) as to Plaintiff's medical records from the Arizona Department of Corrections.
E. Plaintiff's "Motion: Prison Litigation Reform Act 1996 (PLRA) Consideration to Continue with Complaint" (Doc. 52)
In his May 4, 2016 filing (Doc. 52), Plaintiff details his attempts to exhaust his administrative remedies before initiating this action. Plaintiff requests that he "continue with complaint."3 The Motion will be denied as moot. The Court has screened the proposed First Amended Complaint, finds that liberally construed, Plaintiff has stated a cause of action, and will require Defendants to answer.
II. CONCLUSION
Based on the foregoing,
IT IS ORDERED granting Plaintiff's "Motion to Amend Complaint" (Doc. 46).
IT IS FURTHER ORDERED that by August 5, 2016, Plaintiff shall lodge a "clean" version of the First Amended Complaint on the court-approved form. Plaintiff shall check the box on the first page of the form indicating that the document is a "First Amended Complaint." The First Amended Complaint shall contain the identical amendments proposed in the "Motion to Amend Complaint" (Doc. 46). No additional information may be added. If the First Amended Complaint complies with this Order, the Court will issue a separate Order directing the United States Marshals Service ("USMS") to serve the First Amended Complaint on Defendants.
IT IS FURTHER ORDERED directing the Clerk of Court to mail Plaintiff a court-approved form for filing a civil rights complaint by a prisoner.
IT IS FURTHER ORDERED denying Plaintiff's "Recommendation to be Appointed Counsel" (Doc. 49).
IT IS FURTHER ORDERED denying without prejudice Plaintiff's "Discovery Request to be Examined by an Outside Physican [sic]" (Doc. 50).
IT IS FURTHER ORDERED granting in part and denying in part Plaintiff's "Discovery Request to Subpoena Durango Jail-Juvenile Referral and Arizona Department of Corrections for Medical Records" (Doc. 51) as set forth herein. The Clerk of Court is directed to mail Plaintiff one blank subpoena duces tecum for Plaintiff to fill out in accordance with Rule 45, Fed. R. Civ. P. Plaintiff shall promptly send the properly completed subpoena back to the Clerk of Court. The Clerk of Court will then forward the properly completed subpoena duces tecum to the USMS for service.
IT IS FURTHER ORDERED that in light of the Orders set forth herein, Defendant Ryan and Pratt's Motion for Summary Judgment (Doc. 55) is premature, and the Clerk of Court is directed to withdraw the Motion (Doc. 55).
IT IS FURTHER ORDERED denying as moot "Motion: Prison Litigation Reform Act 1996 (PLRA) Consideration to Continue with Complaint" (Doc. 52). Plaintiff's First Amended Complaint has been screened and Defendants shall be ordered to answer.
Instructions for a Prisoner Filing a Civil Rights Complaint in the United States District Court for the District of Arizona
1. Who May Use This Form. The civil rights complaint form is designed to help incarcerated persons prepare a complaint seeking relief for a violation of their federal civil rights. These complaints typically concern, but are not limited to, conditions of confinement. This form should not be used to challenge your conviction or sentence. If you want to challenge a state conviction or sentence, you should file a petition under 28 U.S.C. § 2254 for a writ of habeas corpus by a person in state custody. If you want to challenge a federal conviction or sentence, you should file a motion under 28 U.S.C. § 2255 to vacate sentence in the federal court that entered the judgment.
2. The Form. Local Rule of Civil Procedure (LRCiv) 3.4(a) provides that complaints by incarcerated persons must be filed on the court-approved form. The form must be typed or neatly handwritten. The form must be completely filled in to the extent applicable. All questions must be answered clearly and concisely in the appropriate space on the form. If needed, you may attach additional pages, but no more than fifteen additional pages, of standard letter-sized paper. You must identify which part of the complaint is being continued and number all pages. If you do not fill out the form properly, you will be asked to submit additional or corrected information, which may delay the processing of your action. You do not need to cite law.
3. Your Signature. You must tell the truth and sign the form. If you make a false statement of a material fact, you may be prosecuted for perjury.
4. The Filing Fee. The filing fee for this action is $350.00. If you are unable to immediately pay the filing fee, you may request leave to proceed in forma pauperis. Please review the "Information for Prisoners Seeking Leave to Proceed with a (Non-Habeas) Civil Action in Federal Court In Forma Pauper's Pursuant to 28 U.S.C. § 1915" for additional instructions.
5. Original and Judge's Copy. You must send an original plus one copy of your complaint and of any other documents submitted to the Court. You must send one additional copy to the Court if you wish to have a file-stamped copy of the document returned to you. All copies must be identical to the original. Copies may be legibly handwritten.
6. Where to File. You should file your complaint in the division where you were confined when your rights were allegedly violated. See LRCiv 5.1(a) and 77.1(a). If you were confined in Maricopa, Pinal, Yuma, La Paz, or Gila County, file in the Phoenix Division. If you were confined in Apache, Navajo, Coconino, Mohave, or Yavapai County, file in the Prescott Division. Ifyou were confined in Pima, Cochise, Santa Cruz, Graham, or Greenlee County, file in the Tucson Division. Mail the original and one copy of the complaint with the $350 filing fee or the application to proceed in forma pauperis to:
Phoenix & Prescott Divisions: OR Tucson Division:
U.S. District Court Clerk U.S. District Court Clerk
U.S. Courthouse, Suite 130 U.S. Courthouse, Suite 1500
401 West Washington Street, SPC 10 405 West Congress Street
Phoenix, Arizona 85003-2119 Tucson, Arizona 85701-5010
7. Change of Address. You must immediately notify the Court and the defendants in writing of any change in your mailing address. Failure to notify the Court of any change in your mailing address may result in the dismissal of your case.
8. Certificate of Service. You must furnish the defendants with a copy of any document you submit to the Court (except the initial complaint and application to proceed in forma pauperis). Each original document (except the initial complaint and application to proceed in forma pauperis) must include a certificate of service on the last page of the document stating the date a copy of the document was mailed to the defendants and the address to which it was mailed. See Fed. R. Civ. P. 5(a), (d). Any document received by the Court that does not include a certificate of service may be stricken. A certificate of service should be in the following form:
I hereby certify that a copy of the foregoing document was mailed
this ______________ (month, day, year) to:
Name: ________________________
Address: _____________________
Attorney for Defendant(s)
_______________________________
(Signature)
9. Amended Complaint. If you need to change any of the information in the initial complaint, you must file an amended complaint. The amended complaint must be written on the courtapproved civil rights complaint form. You may file one amended complaint without leave (permission) of Court before any defendant has answered your original complaint. See Fed. R. Civ. P. 15(a). After any defendant has filed an answer, you must file a motion for leave to amend and lodge (submit) a proposed amended complaint. LRCiv 15.1. In addition, an amended complaint may not incorporate by reference any part of your prior complaint. LRCiv 15.1(a)(2). Any allegations or defendants not included in the amended complaint are considered dismissed. All amended complaints are subject to screening under the Prison Litigation Reform Act; screening your amendment will take additional processing time.
10. Exhibits. You should not submit exhibits with the complaint or amended complaint. Instead, the relevant information should be paraphrased. You should keep the exhibits to use to support or oppose a motion to dismiss, a motion for summary judgment, or at trial.
11. Letters and Motions. It is generally inappropriate to write a letter to any judge or the staff of any judge. The only appropriate way to communicate with the Court is by filing a written pleading or motion.
12. Completing the Civil Rights Complaint Form.
HEADING:
1. Your Name. Print your name, prison or inmate number, and institutional mailing address on the lines provided.
2. Defendants. If there are four or fewer defendants, print the name of each. If you name more than four defendants, print the name of the first defendant on the first line, write the words "and others" on the second line, and attach an additional page listing the names of all of the defendants. Insert the additional page after page 1 and number it "1-A" at the bottom.
3. Jury Demand. If you want a jury trial, you must write "JURY TRIAL DEMANDED" in the space below "CIVIL RIGHTS COMPLAINT BY A PRISONER." Failure to do so may result in the loss of the right to a jury trial. A jury trial is not available if you are seeking only injunctive relief.
Part A. JURISDICTION:
1. Nature of Suit. Mark whether you are filing the complaint pursuant to 42 U.S.C. § 1983 for state, county, or city defendants; "Bivens v. Six Unknown Federal Narcotics Agents" for federal defendants; or "other." If you mark "other," identify the source of that authority.
2. Location. Identify the institution and city where the alleged violation of your rights occurred.
3. Defendants. Print all of the requested information about each of the defendants in the spaces provided. If you are naming more than four defendants, you must provide the necessary information about each additional defendant on separate pages labeled "2-A," "2-B," etc., at the bottom. Insert the additional page(s) immediately behind page 2.
Part B. PREVIOUS LAWSUITS:
You must identify any other lawsuit you have filed in either state or federal court while you were a prisoner. Print all of the requested information about each lawsuit in the spaces provided. If you have filed more than three lawsuits, you must provide the necessary information about each additional lawsuit on a separate page. Label the page(s) as "2-A," "2-B," etc., at the bottom of the page and insert the additional page(s) immediately behind page 2.
Part C. CAUSE OF ACTION:
You must identify what rights each defendant violated. The form provides space to allege three separate counts (one violation per count). If you are alleging more than three counts, you must provide the necessary information about each additional count on a separate page. Number the additional pages "5-A," "5-B," etc., and insert them immediately behind page 5. Remember that you are limited to a total of fifteen additional pages.
1. Counts. You must identify which civil right was violated. You may allege the violation of only one civil right per count.
2. Issue Involved. Check the box that most closely identifies the issue involved in your claim. You may check only one box per count. If you check the box marked "Other," you must identify the specific issue involved.
3. Supporting Facts. After you have identified which civil right was violated, you must state the supporting facts. Be as specific as possible. You must state what each individual defendant did to violate your rights. If there is more than one defendant, you must identify which defendant did what act. You also should state the date(s) on which the act(s) occurred, if possible.
4. Injury. State precisely how you were injured by the alleged violation of your rights.
5. Administrative Remedies. You must exhaust any available administrative remedies before you file a civil rights complaint. See 42 U.S.C. § 1997e. Consequently, you should disclose whether you have exhausted the inmate grievance procedures or administrative appeals for each count in your complaint. If the grievance procedures were not available for any of your counts, fully explain why on the lines provided.
Part D. REQUEST FOR RELIEF:
Print the relief you are seeking in the space provided.
SIGNATURE:
You must sign your name and print the date you signed the complaint. Failure to sign the complaint will delay the processing of your action. Unless you are an attorney, you may not bring an action on behalf of anyone but yourself.
FINAL NOTE
You should follow these instructions carefully. Failure to do so may result in your complaint being stricken or dismissed. All questions must be answered concisely in the proper space on the form. If you need more space, you may attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. If you attach additional pages, be sure to identify which section of the complaint is being continued and number the pages.
________________________________________________
Name and Prisoner/Booking Number
________________________________________________
Place of Confinement
________________________________________________
Mailing Address
________________________________________________
City, State, Zip Code
(Failure to notify the Court of your change of address may result in dismissal of this action.)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF ARIZONA
________________________________________________
(Full Name of Plaintiff) Plaintiff,
CASE NO. _____________________________
vs. (To be supplied by the Clerk)
(1) _____________________________
(Full Name of Defendant) CIVIL RIGHTS COMPLAINT
BY A PRISONER
(2) _____________________________
(3) _____________________________ □ Original Complaint
□ First Amended Complaint
(4) _____________________________ □ Second Amended Complaint
Defendant(s).
□ Check if there are additional Defendants and attach page 1-A listing them.
A. JURISDICTION
1. This Court has jurisdiction over this action pursuant to:
□ 28 U.S.C. § 1343(a); 42 U.S.C. § 1983
□ 28 U.S.C. § 1331; Bivens v. Six Unknown Federal Narcotics Agents, 403 U.S. 388 (1971).
□ Other: _______________________________________________________________________________________________
2. Institution/city where violation occurred: __________________________________________
B. DEFENDANTS
1. Name of first Defendant: _________________. The first Defendant is employed as:
__________________________________ at ____________________________________
(Position and Title) (Institution)
2. Name of second Defendant: ___________________. The second Defendant is employed as:
__________________________________ at _____________________________________
(Position and Title) (Institution)
3. Name of third Defendant: ____________________. The third Defendant is employed as:
___________________________________ at ____________________________________________
(Position and Title) (Institution)
4. Name of fourth Defendant: _______________________. The fourth Defendant is employed as:
____________________________________ at _____________________________________
(Position and Title) (Institution)
If you name more than four Defendants, answer the questions listed above for each additional Defendant on a separate page.
C. PREVIOUS LAWSUITS
1. Have you filed any other lawsuits while you were a prisoner? □ Yes □ No
2. If yes, how many lawsuits have you filed? ____. Describe the previous lawsuits:
a. First prior lawsuit:
1. Parties: ______________________________ v.____________________________________________
2. Court and case number: _______________________________________________________________
3. Result: (Was the case dismissed? Was it appealed? Is it still pending?)_______________ ______________________________________________________________________________________________
b. Second prior lawsuit:
1. Parties: _______________________________ v. ___________________________________________
2. Court and case number: ________________________________________________________________
3. Result: (Was the case dismissed? Was it appealed? Is it still pending?)________________ _______________________________________________________________________________________________
c. Third prior lawsuit:
1. Parties: ________________________________ v ____________________________________________.
2. Court and case number: _________________________________________________________________
3. Result: (Was the case dismissed? Was it appealed? Is it still pending?)_________________ ________________________________________________________________________________________________
If you filed more than three lawsuits, answer the questions listed above for each additional lawsuit on a separate page.
D. CAUSE OF ACTION
COUNT I
1. State the constitutional or other federal civil right that was violated: ___________________ ____________________________________________________________________________________________________.
2. Count I. Identify the issue involved. Check only one. State additional issues in separate counts.
□ Basic necessities □ Mail □ Access to the court □ Medical care
□ Disciplinary proceedings □ Property □ Exercise of religion □ Retaliation
□ Excessive force by an officer □ Threat to safety □ Other: ____________________________.
3. Supporting Facts. State as briefly as possible the FACTS supporting Count I. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments. __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________
4. Injury. State how you were injured by the actions or inactions of the Defendant(s). __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________
5. Administrative Remedies:
a. Are there any administrative remedies (grievance procedures or administrative appeals) available
at your institution? □ Yes □ No
b. Did you submit a request for administrative relief on Count I? □ Yes □ No
c. Did you appeal your request for relief on Count I to the highest level? □ Yes □ No
d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why
you did not. _____________________________________________________________________________________________
__________________________________________________________________________________________________________________________
COUNT II
1. State the constitutional or other federal civil right that was violated: ____________________________ _____________________________________________________________________________________________________________
2. Count II. Identify the issue involved. Check only one. State additional issues in separate counts.
□ Basic necessities □ Mail □ Access to the court □ Medical care
□ Disciplinary proceedings □ Property □ Exercise of religion □ Retaliation
□ Excessive force by an officer □ Threat to safety □ Other: __________________________________
3. Supporting Facts. State as briefly as possible the FACTS supporting Count II. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments. ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
4. Injury. State how you were injured by the actions or inactions of the Defendant(s). ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
5. Administrative Remedies.
a. Are there any administrative remedies (grievance procedures or administrative appeals) available
at your institution? □ Yes □ No
b. Did you submit a request for administrative relief on Count II? □ Yes □ No
c. Did you appeal your request for relief on Count II to the highest level? □ Yes □ No
d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why
you did not. ____________________________________________________________________________________________
_________________________________________________________________________________________________________
COUNT III
1. State the constitutional or other federal civil right that was violated: ___________________ _________________________________________________________________________________________________________
2. Count III. Identify the issue involved. Check only one. State additional issues in separate counts.
□ Basic necessities □ Mail □ Access to the court □ Medical care
□ Disciplinary proceedings □ Property □ Exercise of religion □ Retaliation
□ Excessive force by an officer □ Threat to safety □ Other: __________________________________________.
3. Supporting Facts. State as briefly as possible the FACTS supporting Count III. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments. _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________
4. Injury. State how you were injured by the actions or inactions of the Defendant(s). _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________
5. Administrative Remedies.
a. Are there any administrative remedies (grievance procedures or administrative appeals) available
at your institution? □ Yes □ No
b. Did you submit a request for administrative relief on Count III? □ Yes □ No
c. Did you appeal your request for relief on Count III to the highest level? □ Yes □ No
d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why
you did not. ____________________________________________________________________________________________
_________________________________________________________________________________________________________
If you assert more than three Counts, answer the questions listed above for each additional Count on a separate page.
E. REQUEST FOR RELIEF
State the relief you are seeking: _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________
I declare under penalty of perjury that the foregoing is true and correct.
Executed on ______________________ ___________________________
DATE SIGNATURE OF PLAINTIFF
________________________________________________
(Name and title of paralegal, legal assistant, or
other person who helped prepare this complaint)
__________________________________________________
(Signature of attorney, if any)
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
(Attorney's address & telephone number)
ADDITIONAL PAGES
All questions must be answered concisely in the proper space on the form. If you need more space, you may attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. If you attach additional pages, be sure to identify which section of the complaint is being continued and number all pages.
