In addition to Zed's comments: Macfine said: 1) From what I understand to create a customer sheet I need to upgrade to the Pro Tier, If I Ever downgrade from that will I no longer be able to use the sheet anymore in an ongoing campaign? If you downgrade, you will be able to continue using the sheet. You just wont have the Custom Sheet option in the sheet selection dropdown any more. So, advice I always give: make several copies or new campaigns using the custom sheet before you downgrade. That way you have several backups you can use in case the main file gets corrupted, or you want to start a new campaign with the same rules. 3) Players don't need to have pro accounts to be able to use such custom sheets correct? This is correct. The GM (technically, the game's creator) is the only one that needs to be Pro. 2) Just how hard is it to make some minor changes to the standard roll20 sheet? a) such as changing some skill names b) Potentially adding some extra skills. c) Changing the Inspiration symbol to another image. ( not needed, but would be immersive) These vary greatly depending on the sheet. The last one will be easiest - just a matter of finding the url in the sheet's code and swapping it for the URL of the new image you want to use (all images must be uploaded somewhere). If you plan to use the 5e by Roll20 sheet, be aware that the code for that is locked away from prying eyes due to licensing issues. It is possible to find older code, but even in the last version of the publically available code, there were differences between the custom sheet version, and the version you select from the dropdown, due to behind-the-scenes additions the devs had added that are not available in custom sheets. So the custom sheet version isnt the same as the one you get from the dropdown. The shaped sheet on the other hand is in a format that is not very easy to edit. So if you are planning to use a 5e sheet, you might be better off picking one of the other sheets that was forked off the original 5e sheet, like Darker Dungeons (there are several, just naming one for example, not endorsing that one in particulat).