diff --git a/.github/pull_request_template.md b/.github/pull_request_template.md
new file mode 100644
index 0000000..f6fbee7
--- /dev/null
+++ b/.github/pull_request_template.md
@@ -0,0 +1,10 @@
+## Ticket Number
+> Corresponding Jira ticket number
+
+[FFS-0000](https://jiraent.cms.gov/browse/FFS-0000)
+
+## Description of changes
+> Describe the changes so that the reviewer has context
+
+## Screenshots and demonstration
+> If appropriate, provide screenshots or videos to show changes