diff --git a/src/PassReset/index.html b/src/PassReset/index.html
index b8c30ce..bf58441 100644
--- a/src/PassReset/index.html
+++ b/src/PassReset/index.html
@@ -5,6 +5,17 @@
         <title>Password reset</title>
     </head>
     <body>
+        <form>
+            <label for="uid">Username</label>
+            <input type="text" id="uid" name="uid" /> <br />
+            <label for="oldPW">Old Password</label>
+            <input type="text" id="oldPw" name="oldPW" /> <br />
+            <label for="newPW1">New Password</label>
+            <input type="text" id="newPW1" name="newPW" /> <br />
+            <label for="newPW2">Confirm</label>
+            <input type="text" id="newPW2" name="newPWConfirm" /> <br />
+            <input type="Submit" value="Submit" />
+        </form>
         <footer>
             UL Computer Society 2023-<span id="year">2023</span>
         </footer>
