diff --git a/.github/PULL_REQUEST_TEMPLATE/ui_changes.md b/.github/PULL_REQUEST_TEMPLATE/ui_changes.md
new file mode 100644
index 00000000..7e709ddf
--- /dev/null
+++ b/.github/PULL_REQUEST_TEMPLATE/ui_changes.md
@@ -0,0 +1,17 @@
+Resolves #issue_number
+
+<!-- Fixes #issue_number -->
+
+### Changes
+
+### Manual testing
+
+1.
+
+### Screenshots
+
+| Page | Image/video |
+| ---- | ----------- |
+|      |             |
+
+<!-- ### Follow-ups -->