diff --git a/package-lock.json b/package-lock.json
index 57bd2a3..e7189a9 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -11463,9 +11463,9 @@
       "integrity": "sha512-WMwm9LhRUo+WUaRN+vRuETqG89IgZphVSNkdFgeb6sS/E4OrDIN7t48CAewSHXc6C8lefD8KKfr5vY61brQlow=="
     },
     "node_modules/ejs": {
-      "version": "3.1.9",
-      "resolved": "https://registry.npmjs.org/ejs/-/ejs-3.1.9.tgz",
-      "integrity": "sha512-rC+QVNMJWv+MtPgkt0y+0rVEIdbtxVADApW9JXrUVlzHetgcyczP/E7DJmWJ4fJCZF2cPcBk0laWO9ZHMG3DmQ==",
+      "version": "3.1.10",
+      "resolved": "https://registry.npmjs.org/ejs/-/ejs-3.1.10.tgz",
+      "integrity": "sha512-UeJmFfOrAQS8OJWPZ4qtgHyWExa088/MtK5UEyoJGFH67cDEXkZSviOiKRCZ4Xij0zxI3JECgYs3oKx+AizQBA==",
       "dependencies": {
         "jake": "^10.8.5"
       },
diff --git a/src/views/Patient/MedReqDropDown/MedReqDropDown.css b/src/views/Patient/MedReqDropDown/MedReqDropDown.css
index 3ff812b..319ae36 100644
--- a/src/views/Patient/MedReqDropDown/MedReqDropDown.css
+++ b/src/views/Patient/MedReqDropDown/MedReqDropDown.css
@@ -1,7 +1,7 @@
 .etasuButtonText {
   margin-bottom: 0px;
   font-weight: bold;
-  font-size: 14px;
+  font-size: 1.2em;
 }
 
 .etasuButtonTimestamp {
diff --git a/src/views/Patient/MedReqDropDown/MedReqDropDown.tsx b/src/views/Patient/MedReqDropDown/MedReqDropDown.tsx
index 0178a82..add4630 100644
--- a/src/views/Patient/MedReqDropDown/MedReqDropDown.tsx
+++ b/src/views/Patient/MedReqDropDown/MedReqDropDown.tsx
@@ -314,7 +314,7 @@ function MedReqDropDown({
   };
   return (
     <>
-      <Card sx={{ bgcolor: 'white' }}>
+      <Card sx={{ bgcolor: 'white', width: '100%', margin: '0 auto 0' }}>
         <CardContent>
           <Grid item container spacing={2}>
             <Grid item container alignItems="left" direction="column" spacing={2}>
diff --git a/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCard.tsx b/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCard.tsx
index 12afee1..55fb2b6 100644
--- a/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCard.tsx
+++ b/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCard.tsx
@@ -1,18 +1,26 @@
-import { useState, useEffect, ReactElement } from 'react';
-import { Button, Card, CardActions, CardContent, Grid, Typography } from '@mui/material';
+import { Box, Button, Card, CardContent, Grid, Typography } from '@mui/material';
+import { ReactElement, useEffect, useState } from 'react';
 
 import axios from 'axios';
 import Client from 'fhirclient/lib/Client';
 
+import AddCircleOutlineRoundedIcon from '@mui/icons-material/AddCircleOutlineRounded';
+import ArrowForwardIosRoundedIcon from '@mui/icons-material/ArrowForwardIosRounded';
+import KeyboardArrowDownRoundedIcon from '@mui/icons-material/KeyboardArrowDownRounded';
+import PictureAsPdfIcon from '@mui/icons-material/PictureAsPdf';
+import Accordion from '@mui/material/Accordion';
+import AccordionDetails from '@mui/material/AccordionDetails';
+import AccordionSummary from '@mui/material/AccordionSummary';
+import List from '@mui/material/List';
+import ListItem from '@mui/material/ListItem';
 import {
+  Action,
   Card as HooksCard,
   Link,
-  Suggestion,
-  Action
+  Suggestion
 } from '../../../../cds-hooks/resources/HookTypes';
 import { SmartApp } from '../../../Questionnaire/SmartApp';
 import { AppContext, getAppContext } from '../../../Questionnaire/questionnaireUtil';
-import PictureAsPdfIcon from '@mui/icons-material/PictureAsPdf';
 
 // TODO:
 //  - create a css file for better style
@@ -234,78 +242,140 @@ const CdsHooksCard = (props: CdsHooksCardProps) => {
       });
     });
   }
+
   const decisionCard = {
     backgroundColor: '#fff',
     border: '1px solid rgba(0, 0, 0, 0.12)',
     borderRadius: '4px'
   };
+
   const cardSource = { fontSize: '.85rem', fontStyle: 'italic', margin: '0 0 5px' };
   const sourceLink = { marginRight: '8px', color: '#4183c4', textDecoration: 'none' };
+
   return (
-    <Grid item xs={12}>
-      <Card variant="outlined" style={decisionCard}>
+    <Card
+      variant="outlined"
+      style={decisionCard}
+      sx={{ margin: '0 auto 0', marginTop: '20px', maxWidth: '560px' }}
+    >
+      <Box sx={{ margin: '0 auto 0', width: '90%' }}>
         <CardContent>
           <Typography variant="h5" component="div">
             {props.card?.summary}
           </Typography>
-          <Typography>{props.card?.detail}</Typography>
-          <Typography style={cardSource} gutterBottom>
+        </CardContent>
+
+        {/* Forms */}
+        {links.filter(link => link.type === 'smart').length > 0 ? (
+          <div>
+            <Typography color="text.secondary">Required Forms</Typography>
+            <List>
+              {links.map((link: Link) => {
+                if (link.type === 'smart') {
+                  return (
+                    <ListItem key={link?.label}>
+                      <Button
+                        sx={{
+                          display: 'flex',
+                          justifyContent: 'space-between',
+                          alignItems: 'center',
+                          textAlign: 'left',
+                          width: '100%',
+                          marginBottom: '5px'
+                        }}
+                        variant="outlined"
+                        onClick={() => buttonClickAction(link)}
+                        endIcon={<ArrowForwardIosRoundedIcon />}
+                      >
+                        {link?.label}
+                      </Button>
+                    </ListItem>
+                  );
+                }
+              })}
+            </List>
+          </div>
+        ) : (
+          <></>
+        )}
+
+        {/* Suggestions */}
+        {suggestions.length > 0 ? (
+          <div>
+            <Typography sx={{ marginTop: '10px' }} color="text.secondary">
+              Suggestions
+            </Typography>
+            <List>
+              {suggestions.map((suggestion: Suggestion, ind) => {
+                const buttonId = 'suggestion_button-' + props.cardInd + '-' + ind;
+                return (
+                  <ListItem key={suggestion?.label}>
+                    <Button
+                      variant="contained"
+                      endIcon={<AddCircleOutlineRoundedIcon />}
+                      onClick={() =>
+                        buttonClickSuggestion(
+                          suggestion,
+                          buttonId,
+                          suggestions.length,
+                          props.cardInd,
+                          props.selectionBehavior
+                        )
+                      }
+                      id={buttonId}
+                    >
+                      {suggestion?.label}
+                    </Button>
+                  </ListItem>
+                );
+              })}
+            </List>
+          </div>
+        ) : (
+          <></>
+        )}
+
+        {/* Documentation and Guides */}
+        {links.filter(link => link.type === 'absolute').length > 0 ? (
+          <Accordion
+            sx={{ display: 'block', marginTop: '10px', width: '100%', backgroundColor: '#F3F6F9' }}
+          >
+            <AccordionSummary expandIcon={<KeyboardArrowDownRoundedIcon />}>
+              <Typography sx={{ fontSize: 14 }} color="text.secondary">
+                View documentation and guides
+              </Typography>
+            </AccordionSummary>
+            <AccordionDetails>
+              {links.map((link: Link) => {
+                if (link.type === 'absolute') {
+                  return (
+                    <Grid item key={link?.label}>
+                      <Button
+                        endIcon={<PictureAsPdfIcon />}
+                        onClick={() => buttonClickAction(link)}
+                      >
+                        {link?.label}
+                      </Button>
+                    </Grid>
+                  );
+                }
+              })}
+            </AccordionDetails>
+          </Accordion>
+        ) : (
+          <></>
+        )}
+
+        <Box sx={{ textAlign: 'right', paddingTop: '10px' }}>
+          <Typography style={cardSource}>
             {'Source '}
             <a href={props.card?.source?.url} style={sourceLink}>
               {props.card?.source?.label}
             </a>
           </Typography>
-        </CardContent>
-        <CardActions>
-          <Grid container spacing={1}>
-            {links.map((link: Link) => {
-              if (link.type === 'smart') {
-                return (
-                  <Grid item key={link?.label}>
-                    <Button variant="outlined" onClick={() => buttonClickAction(link)}>
-                      {link?.label}
-                    </Button>
-                  </Grid>
-                );
-              }
-              return (
-                <Grid item key={link?.label}>
-                  <Button endIcon={<PictureAsPdfIcon />} onClick={() => buttonClickAction(link)}>
-                    {link?.label}
-                  </Button>
-                </Grid>
-              );
-            })}
-          </Grid>
-        </CardActions>
-        <CardActions>
-          <Grid container spacing={1}>
-            {suggestions.map((suggestion: Suggestion, ind) => {
-              const buttonId = 'suggestion_button-' + props.cardInd + '-' + ind;
-              return (
-                <Grid item key={suggestion?.label}>
-                  <Button
-                    variant="contained"
-                    onClick={() =>
-                      buttonClickSuggestion(
-                        suggestion,
-                        buttonId,
-                        suggestions.length,
-                        props.cardInd,
-                        props.selectionBehavior
-                      )
-                    }
-                    id={buttonId}
-                  >
-                    {suggestion?.label}
-                  </Button>
-                </Grid>
-              );
-            })}
-          </Grid>
-        </CardActions>
-      </Card>
-    </Grid>
+        </Box>
+      </Box>
+    </Card>
   );
 };
 
diff --git a/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCards.tsx b/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCards.tsx
index 2112313..374b47e 100644
--- a/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCards.tsx
+++ b/src/views/Patient/MedReqDropDown/cdsHooksCards/cdsHooksCards.tsx
@@ -15,7 +15,7 @@ interface CdsHooksCardsProps {
 
 const CdsHooksCards = (props: CdsHooksCardsProps) => {
   return (
-    <Grid item container spacing={2}>
+    <Grid item container spacing={2} maxWidth={'600px'} margin={'0 auto 0'}>
       {props.cards.map((card: HooksCard, cardInd) => (
         <CdsHooksCard
           key={card?.summary}
diff --git a/src/views/Patient/MedReqDropDown/etasuStatus/EtasuStatus.tsx b/src/views/Patient/MedReqDropDown/etasuStatus/EtasuStatus.tsx
index 9350a3a..b8ff041 100644
--- a/src/views/Patient/MedReqDropDown/etasuStatus/EtasuStatus.tsx
+++ b/src/views/Patient/MedReqDropDown/etasuStatus/EtasuStatus.tsx
@@ -98,22 +98,29 @@ const EtasuStatus = (props: EtasuStatusProps) => {
         <Box sx={{ width: '100%', maxWidth: 360, bgcolor: 'background.paper' }}>
           {props.remsAdminResponse ? (
             <List>
-              {getRequirements().map((param: EtasuParamParam) => (
-                <ListItem disablePadding key={param.name} data-testid="etasu-item">
-                  <ListItemIcon>
-                    {param.resource.status === 'success' ? (
-                      <CheckCircle color="success" />
-                    ) : (
-                      <Close color="warning" />
-                    )}
-                  </ListItemIcon>
-                  {param.resource.status === 'success' ? (
-                    <ListItemText primary={param.name} />
-                  ) : (
-                    <ListItemText primary={param.name} secondary={param.resource.note?.[0]?.text} />
-                  )}
-                </ListItem>
-              ))}
+              {getRequirements().map((param: EtasuParamParam) => {
+                if (param.resource) {
+                  return (
+                    <ListItem disablePadding key={param.name} data-testid="etasu-item">
+                      <ListItemIcon>
+                        {param.resource?.status === 'success' ? (
+                          <CheckCircle color="success" />
+                        ) : (
+                          <Close color="warning" />
+                        )}
+                      </ListItemIcon>
+                      {param.resource?.status === 'success' ? (
+                        <ListItemText primary={param.name} />
+                      ) : (
+                        <ListItemText
+                          primary={param.name}
+                          secondary={param.resource?.note?.[0]?.text}
+                        />
+                      )}
+                    </ListItem>
+                  );
+                }
+              })}
             </List>
           ) : (
             'Not Available'
diff --git a/src/views/Questionnaire/QuestionnaireForm.tsx b/src/views/Questionnaire/QuestionnaireForm.tsx
index 4031b61..3ce0405 100644
--- a/src/views/Questionnaire/QuestionnaireForm.tsx
+++ b/src/views/Questionnaire/QuestionnaireForm.tsx
@@ -10,6 +10,7 @@ import {
   Meta,
   Organization,
   Parameters,
+  Patient,
   Questionnaire,
   QuestionnaireItem,
   QuestionnaireResponse,
@@ -44,7 +45,7 @@ import Client from 'fhirclient/lib/Client';
 import ConfigData from '../../config.json';
 import { SelectPopup } from './components/SelectPopup';
 import AlertDialog from './components/AlertDialog';
-
+import { RemsAdminResponse } from './components/RemsInterface/RemsInterface';
 import { PrepopulationResults } from './SmartApp';
 import { v4 as uuid } from 'uuid';
 import axios, { AxiosResponse } from 'axios';
@@ -223,10 +224,15 @@ export function QuestionnaireForm(props: QuestionnaireProps) {
   const [popupState, popupDispatch] = useReducer(reducer, initialPopupState);
   const [showRxAlert, setShowRxAlert] = useState<RxAlert>({ open: false });
   const [formValidationErrors, setFormValidationErrors] = useState<any[]>([]);
+  const [patient, setPatient] = useState<Patient | undefined>(undefined);
   const LForms = window.LForms;
   const questionnaireFormId = `formContainer-${props.questionnaireForm.id}-${props.tabIndex}`;
 
   useEffect(() => {
+    const patientId = getPatient();
+    props.smartClient.request(patientId).then(res => {
+      setPatient(res);
+    });
     // search for any partially completed QuestionnaireResponses
     if (props.response) {
       const response = props.response;
@@ -1139,7 +1145,7 @@ export function QuestionnaireForm(props: QuestionnaireProps) {
   // Get tooltip for Submit button
   const getMissingFieldsTooltip = () => {
     const tooltip = isFilledOut() ? 'Submit to REMS admin' : 'Fill out missing fields';
-    return <Typography fontSize={16}>{tooltip}</Typography>;
+    return <Typography fontSize={'small'}>{tooltip}</Typography>;
   };
 
   // Get missing fields to display
@@ -1734,8 +1740,42 @@ export function QuestionnaireForm(props: QuestionnaireProps) {
             specialtyRxBundle,
             options
           )
-          .then(response => {
+          .then((response: RemsAdminResponse) => {
+            const remsCaseUrl = 'http://hl7.org/fhir/sid/rems-case'; // placeholder
             const proceedToRems = () => {
+              const caseNumber = response.data?.case_number;
+              if (caseNumber && patient) {
+                patient.identifier = patient.identifier?.filter(iden => {
+                  if (iden.system === remsCaseUrl && iden.period) {
+                    if (iden.period?.end) {
+                      const endDate = new Date(iden.period.end);
+                      if (endDate.getMilliseconds() < Date.now()) {
+                        return false; // filter out old identifiers
+                      }
+                    }
+                  }
+                  return true;
+                });
+                const endDate = new Date(Date.now() + 86400000); // 86400000 is 1 day in milliseconds
+                patient.identifier?.push({
+                  value: caseNumber,
+                  system: remsCaseUrl,
+                  period: {
+                    start: new Date(Date.now()).toISOString(),
+                    end: endDate.toISOString()
+                  }
+                });
+                // update patient
+                props.smartClient.request({
+                  url: patient.resourceType + '/' + patient.id,
+                  method: 'PUT',
+                  headers: {
+                    'content-type': 'application/json'
+                  },
+                  body: JSON.stringify(patient)
+                });
+              }
+
               props.setSpecialtyRxBundle(specialtyRxBundle);
             };
             if (response.status == 201) {
diff --git a/src/views/Questionnaire/SmartApp.tsx b/src/views/Questionnaire/SmartApp.tsx
index d778469..991af3e 100644
--- a/src/views/Questionnaire/SmartApp.tsx
+++ b/src/views/Questionnaire/SmartApp.tsx
@@ -723,7 +723,7 @@ export function SmartApp(props: SmartAppProps) {
   } else {
     return (
       <div className="App">
-        <p>Loading...</p>
+        <h1>Loading...</h1>
       </div>
     );
   }
diff --git a/src/views/Questionnaire/components/PatientSelect/PatientStyles.css b/src/views/Questionnaire/components/PatientSelect/PatientStyles.css
index bac36f4..d1811b6 100644
--- a/src/views/Questionnaire/components/PatientSelect/PatientStyles.css
+++ b/src/views/Questionnaire/components/PatientSelect/PatientStyles.css
@@ -7,7 +7,7 @@
     height:500px;
     width:70%;
     z-index:1;
-    font-size:14px;
+    font-size:1.3em;
     background-color: #f9f9f9;
     border: 1px solid black;
 }
@@ -16,7 +16,7 @@
     position: absolute;
     left:14%;
     top:3px;
-    font-size: 20px;
+    font-size: 1.5em;
     padding: 15px;
     margin: 10px;
 }
diff --git a/src/views/Questionnaire/components/RemsInterface/RemsInterface.css b/src/views/Questionnaire/components/RemsInterface/RemsInterface.css
index 445c9c6..746703e 100644
--- a/src/views/Questionnaire/components/RemsInterface/RemsInterface.css
+++ b/src/views/Questionnaire/components/RemsInterface/RemsInterface.css
@@ -70,7 +70,7 @@ body {
 .jsonData {
   line-height: 16px;
   font-family: 'Courier New', Courier, monospace;
-  font-size: 14px;
+  font-size: 1.3em;
 
   border-left: 2px solid #dddddd;
   border-top: 0px;
diff --git a/src/views/Questionnaire/components/RemsInterface/RemsInterface.tsx b/src/views/Questionnaire/components/RemsInterface/RemsInterface.tsx
index a85bf90..dc993e6 100644
--- a/src/views/Questionnaire/components/RemsInterface/RemsInterface.tsx
+++ b/src/views/Questionnaire/components/RemsInterface/RemsInterface.tsx
@@ -5,10 +5,26 @@ import Paper from '@mui/material/Paper';
 import Button from '@mui/material/Button';
 import { Bundle } from 'fhir/r4';
 import { Box } from '@mui/material';
+import { AxiosResponse } from 'axios';
 
 interface RemsInterfaceProps {
   specialtyRxBundle: Bundle;
 }
+export interface RemsAdminResponse extends AxiosResponse {
+  data: JsonData;
+}
+
+type MetRequirements = {
+  completed: boolean;
+  requirementName: string;
+  requirementDescription: string;
+};
+
+interface JsonData {
+  case_number: string;
+  status: string;
+  metRequirements: MetRequirements[];
+}
 
 export default function RemsInterface(props: RemsInterfaceProps) {
   const [viewBundle, setViewBundle] = useState<boolean>(false);
diff --git a/src/views/Smart/Index.tsx b/src/views/Smart/Index.tsx
index 6e40010..41ec967 100644
--- a/src/views/Smart/Index.tsx
+++ b/src/views/Smart/Index.tsx
@@ -10,6 +10,7 @@ const Index = () => {
     FHIR.oauth2.ready().then(client => {
       setClient(client);
     });
+    document.title = 'REMS SMART on FHIR app';
   }, []);
 
   return (
diff --git a/src/views/Smart/Launch.tsx b/src/views/Smart/Launch.tsx
index 9c9738e..b1816af 100644
--- a/src/views/Smart/Launch.tsx
+++ b/src/views/Smart/Launch.tsx
@@ -13,6 +13,7 @@ const Launch = () => {
     </div>
   );
   useEffect(() => {
+    document.title = 'REMS SMART on FHIR app launch page';
     smartLaunch();
   }, []);
 
diff --git a/src/views/Smart/Register.tsx b/src/views/Smart/Register.tsx
index fa4ba1d..680bbef 100644
--- a/src/views/Smart/Register.tsx
+++ b/src/views/Smart/Register.tsx
@@ -1,5 +1,5 @@
 import { Button, FormControl, FormHelperText, IconButton, TextField } from '@mui/material';
-import React, { FormEvent, memo, useState } from 'react';
+import React, { FormEvent, memo, useState, useEffect } from 'react';
 import CloseIcon from '@mui/icons-material/Close';
 
 interface RegisterProps {
@@ -9,7 +9,9 @@ interface RegisterProps {
 const Register = (props: RegisterProps) => {
   const [clientId, setClientId] = useState<string>('');
   const [fhirUrl, setFhirUrl] = useState<string>(props.fhirUrl || '');
-
+  useEffect(() => {
+    document.title = 'Registration page for SMART on FHIR clients';
+  });
   const [currentClients, setCurrentClients] = useState(
     JSON.parse(localStorage.getItem('clients') || '[]')
   );