diff --git a/.github/PULL_REQUEST_TEMPLATE.md b/.github/PULL_REQUEST_TEMPLATE.md
index b289a1c0..af052392 100644
--- a/.github/PULL_REQUEST_TEMPLATE.md
+++ b/.github/PULL_REQUEST_TEMPLATE.md
@@ -1,11 +1,19 @@
-Fixes #[issue number] .
+_This template was created based on the work of [`udemy-dl`](https://github.com/nishad/udemy-dl/blob/master/LICENSE)._
 
-Changes proposed in this pull request:
+**By submitting this pull request, I confirm the following (please check boxes, eg [X]):**
 
-- 
+- [ ] I have read and understood the [contributors guide](https://github.com/pi-hole/pi-hole/blob/master/CONTRIBUTING.md).
+- [ ] I have checked that [another pull request](https://github.com/pi-hole/pi-hole/pulls) for this purpose does not exist.
+- [ ] I have considered, and confirmed that this submission will be valuable to others.
+- [ ] I accept that this submission may not be used, and the pull request closed at the will of the maintainer.
+- [ ] I give this submission freely, and claim no ownership to its content.
 
-- 
+**My familiarity with the project is as follows (check one, eg [X]):**
 
-- 
+- [ ] I have never used the project.
+- [ ] I have used the project briefly.
+- [ ] I have used the project extensively, but have not contributed previously.
+- [ ] I am an active contributor to the project.
 
-@pi-hole/gravity
+---
+_{replace this line with your pull request content}_