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+<!DOCTYPE html>
+<html lang="en">
+<head>
+    <meta charset="UTF-8">
+    <meta name="viewport" content="width=device-width, initial-scale=1.0">
+    <title>CCAH IT Assessment Questionnaire</title>
+    <!-- Bootstrap CDN -->
+    <link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.2/dist/css/bootstrap.min.css">
+    <link rel="stylesheet" href="../assets/css/styles.css">
+</head>
+<body>
+    <div class="container mt-4">
+        <div class="text-center mb-4">
+            <img src="../assets/img/ccah-logo.png" alt="CCAH Logo" style="max-height:100px;">
+        </div>
+        <h3 class="text-center">CCAH IT Assessment Questionnaire</h3>
+        <form id="assessment-form">
+            <!-- Sample question block -->
+            <div class="mb-3">
+                <label class="form-label">Role/Title at CCAH</label>
+                <input type="text" class="form-control" name="role" required>
+            </div>
+            
+            <!-- Add more questions similarly -->
+            
+            <button type="submit" class="btn btn-primary">Submit</button>
+        </form>
+    </div>
+
+    <!-- Bootstrap JS -->
+    <script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.2/dist/js/bootstrap.bundle.min.js"></script>
+    <script src="../assets/js/main.js"></script>
+</body>
+</html>
