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diff --git a/.github/ISSUE_TEMPLATE/universal_pipeline_update.md b/.github/ISSUE_TEMPLATE/universal_pipeline_update.md
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+---
+name: SimpleReport (New Universal Pipeline Update)
+about: Checklist for followups after a state has been added to the universal pipeline
+title: "[ UNIVERSAL PIPELINE UPDATE]"
+labels: Needs refinement
+assignees: ""
+---
+
+### Background
+
+The state of {STATE NAME} went live on the universal pipeline on {DD MMM YYYY}.
+The UP config list needs to be updated on [simplereport.gov](simplereport.gov) and
+an announcement email needs to go out to senders in that state.
+
+### Action requested
+
+Updates are needed in the following areas:
+
+- [ ] Update [the list of UP states](https://github.com/CDCgov/prime-simplereport-site/blob/a745bf8383ae9c0a10dcfa26a48340dd9c905d64/_config.yml#L61) on the static site config. Refer to [this PR](https://github.com/CDCgov/prime-simplereport-site/blob/a745bf8383ae9c0a10dcfa26a48340dd9c905d64/_config.yml#L61) for an example
+- [ ] Generate the list of admin emails senders in that state for product to make an announcement using the `sendOrgAdminEmailCSV` mutation. Notify product once this list is generated so they can continue with the email campaign.