Perry v. SSM Health et al

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
JAMIE PHILLIP PERRY, 	)
)
)
Plaintiff, 	)
)
v. 	) 	No. 4:25-CV-01613 SPM
)
SSM HEALTH, et al., 	)
)
)
Defendants. 	)
MEMORANDUM AND ORDER
This matter is before the Court upon review of self-represented Plaintiff Jamie Perry’s
document titled “Office of the Clerk Civil Action Lawsuit” received by this Court on October 29,
2025, [ECF No. 1], which the Court construes as a civil rights Complaint under 42 U.S.C. § 1983.
The Complaint is defective because it has not been drafted on a Court-provided form. See E.D.
Mo. L.R. 2.06(A) (“All actions brought by self-represented plaintiffs or petitioners should be filed
on Court-provided forms”). Additionally, Plaintiff has neither paid the $405 filing fee nor filed an
Application to Proceed in the District Court without Prepaying Fees or Costs. See 28 U.S.C. §
1915(a).
Accordingly,
IT IS HEREBY ORDERED that the Clerk is directed to mail Plaintiff (1) a copy of the
Court’s Prisoner Civil Rights Complaint form and (2) a copy of the Application to Proceed in the
District Court without Prepaying Fees or Costs.
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IT IS FURTHER ORDERED that Plaintiff must either pay the $405 filing fee or submit
the Application to Proceed in the District Court without Prepaying Fees or Costs within twenty-
one (21) days of the date of this Order.
IT IS FURTHER ORDERED that if Plaintiff chooses to submit an Application to
Proceed in the District Court without Prepaying Fees or Costs, he must also submit a copy of his
certified account statement for the six-month period immediately preceding the filing of the
Complaint.
IT IS FURTHER ORDERED that Plaintiff must file an Amended Complaint on the
Court-provided form within twenty-one (21) days of the date of this Order.
IT IS FURTHER ORDERED if Plaintiff fails to comply with this Order, the Court will
dismiss this action without prejudice and without further notice to Plaintiff.
Dated this 12th day of November, 2025.
SHIRLEY PADMORE MENSAH
UNITED STATES MAGISTRATE JUDGE
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