diff --git a/src/components/RequestBox/RequestBox.jsx b/src/components/RequestBox/RequestBox.jsx
index 4765b33..2b59035 100644
--- a/src/components/RequestBox/RequestBox.jsx
+++ b/src/components/RequestBox/RequestBox.jsx
@@ -6,14 +6,15 @@ import MuiAlert from '@mui/material/Alert';
 import Snackbar from '@mui/material/Snackbar';
 import { shortNameMap } from '../../util/data.js';
 import { getAge, createMedicationDispenseFromMedicationRequest } from '../../util/fhir.js';
-import { retrieveLaunchContext } from '../../util/util.js';
+import { retrieveLaunchContext, prepPrefetch } from '../../util/util.js';
 import './request.css';
 
 const RequestBox = props => {
   const [state, setState] = useState({
     gatherCount: 0,
     response: {},
-    submittedRx: false
+    submittedRx: false,
+    prefetchCompleted: false
   });
 
   const {
@@ -29,52 +30,36 @@ const RequestBox = props => {
     smartAppUrl,
     client,
     pimsUrl,
+    prefetchCompleted,
     getRemsAdminUrl
   } = props;
   const emptyField = <span className="empty-field">empty</span>;
 
-  const prepPrefetch = () => {
-    const preppedResources = new Map();
-    Object.keys(prefetchedResources).forEach(resourceKey => {
-      let resourceList = [];
-      if (Array.isArray(prefetchedResources[resourceKey])) {
-        resourceList = prefetchedResources[resourceKey].map(resource => {
-          return resource;
-        });
-      } else {
-        resourceList = prefetchedResources[resourceKey];
-      }
-
-      preppedResources.set(resourceKey, resourceList);
-    });
-    return preppedResources;
-  };
-
   const submitPatientView = () => {
-    submitInfo(prepPrefetch(), null, patient, 'patient-view');
+    submitInfo(prepPrefetch(prefetchedResources), null, patient, 'patient-view');
   };
 
   const _submitOrderSelect = () => {
     if (!_.isEmpty(request)) {
-      submitInfo(prepPrefetch(), request, patient, 'order-select');
+      submitInfo(prepPrefetch(prefetchedResources), request, patient, 'order-select');
     }
   };
 
   const submitOrderSign = request => {
     if (!_.isEmpty(request)) {
-      submitInfo(prepPrefetch(), request, patient, 'order-sign');
+      submitInfo(prepPrefetch(prefetchedResources), request, patient, 'order-sign');
     }
   };
 
   useEffect(() => {
     // if prefetch completed
-    if (state.prefetchCompleted) {
+    if (props.prefetchCompleted) {
       // if the prefetch contains a medicationRequests bundle
       if (prefetchedResources.medicationRequests) {
         submitPatientView();
       }
     }
-  }, [state.prefetchCompleted]);
+  }, [props.prefetchCompleted]);
 
   const renderPatientInfo = () => {
     if (Object.keys(patient).length === 0) {
diff --git a/src/components/SMARTBox/PatientBox.jsx b/src/components/SMARTBox/PatientBox.jsx
index d200735..885252c 100644
--- a/src/components/SMARTBox/PatientBox.jsx
+++ b/src/components/SMARTBox/PatientBox.jsx
@@ -278,6 +278,7 @@ const PatientBox = props => {
         response: ''
       }));
       callback('response', '');
+      clearCallback();
       // update prefetch request for the medication
       const request = JSON.parse(data);
       if (
diff --git a/src/containers/RequestBuilder.jsx b/src/containers/RequestBuilder.jsx
index 60bdb5a..ca53471 100644
--- a/src/containers/RequestBuilder.jsx
+++ b/src/containers/RequestBuilder.jsx
@@ -8,7 +8,7 @@ import RequestBox from '../components/RequestBox/RequestBox.jsx';
 import buildRequest from '../util/buildRequest.js';
 import { types } from '../util/data.js';
 import { createJwt } from '../util/auth.js';
-import { getMedicationSpecificRemsAdminUrl } from '../util/util.js';
+import { getMedicationSpecificRemsAdminUrl, prepPrefetch } from '../util/util.js';
 
 import Accordion from '@mui/material/Accordion';
 import AccordionSummary from '@mui/material/AccordionSummary';
@@ -40,7 +40,9 @@ const RequestBuilder = props => {
     token: null,
     client: client,
     medicationDispense: null,
-    lastCheckedMedicationTime: null
+    lastCheckedMedicationTime: null,
+    prefetchCompleted: false,
+    medicationRequests: {}
   });
   const displayRequestBox = !!globalState.patient?.id;
 
@@ -101,9 +103,56 @@ const RequestBuilder = props => {
     }
   };
 
+  const getMedicationRequests = patientId => {
+    client
+      .request(`MedicationRequest?subject=Patient/${patientId}`, {
+        resolveReferences: ['subject', 'performer', 'medicationReference'],
+        graph: false,
+        flat: true
+      })
+      .then(result => {
+        setState(prevState => ({ ...prevState, medicationRequests: result }));
+      });
+  };
+
+
+  useEffect(() => {
+    const hook = 'patient-view';
+
+    let remsAdminUrls = [];
+    // get all the remsAdminUrl for each MedicationRequest
+    state.medicationRequests?.data?.forEach(request => {
+      const code = request?.medicationCodeableConcept?.coding[0]?.code;
+      const remsAdminUrl = getMedicationSpecificRemsAdminUrl(request, globalState, hook);
+      if (remsAdminUrl) {
+        remsAdminUrls.push(remsAdminUrl);
+      }
+      //sendHook(prefetch, request, patient, hook, remsAdminUrl);
+    });
+    const uniqueUrls = [... new Set(remsAdminUrls.map(item => item))];
+
+    uniqueUrls?.forEach(url => {
+      sendHook(prepPrefetch(state.prefetchedResources), null, globalState.patient, hook, url);
+      //TODO: still need to handle multiple sends and multiple cards coming back
+    });
+
+  }, [state.medicationRequests]);
+
   const submitInfo = (prefetch, request, patient, hook) => {
     console.log('Initiating form submission ', types.info);
-    const remsAdminUrl = getMedicationSpecificRemsAdminUrl(request, globalState, hook);
+    let remsAdminUrl = null;
+    if (request) {
+      remsAdminUrl = getMedicationSpecificRemsAdminUrl(request, globalState, hook);
+      sendHook(prefetch, request, patient, hook, remsAdminUrl);
+    } else {
+      // grab all of the REMS admins for the medications for this patient
+
+      // get all MedicationRequests for the patient, then continue
+      getMedicationRequests(patient.id);
+    }
+  };
+
+  const sendHook = (prefetch, request, patient, hook, remsAdminUrl) => {
 
     setState(prevState => ({
       ...prevState,
@@ -292,6 +341,7 @@ const RequestBuilder = props => {
                 defaultUser={globalState.defaultUser}
                 loading={state.loading}
                 patientFhirQuery={globalState.patientFhirQuery}
+                prefetchCompleted={state.prefetchCompleted}
                 getRemsAdminUrl={(request, hook) =>
                   getMedicationSpecificRemsAdminUrl(request, globalState, hook)
                 }
diff --git a/src/util/util.js b/src/util/util.js
index 44b9286..f494e61 100644
--- a/src/util/util.js
+++ b/src/util/util.js
@@ -92,6 +92,10 @@ function standardsBasedGetEtasu(etasuUrl, body, responseCallback) {
 }
 
 const getMedicationSpecificRemsAdminUrl = (request, globalState, hook) => {
+  // if empty request, just return
+  if (Object.keys(request).length === 0) {
+    return undefined;
+  }
   const display = request.medicationCodeableConcept?.coding?.[0]?.display;
   const rxnorm = request.medicationCodeableConcept?.coding?.[0]?.code;
 
@@ -117,4 +121,21 @@ const getMedicationSpecificRemsAdminUrl = (request, globalState, hook) => {
   return cdsUrl;
 };
 
-export { retrieveLaunchContext, standardsBasedGetEtasu, getMedicationSpecificRemsAdminUrl };
+const prepPrefetch = (prefetchedResources) => {
+  const preppedResources = new Map();
+  Object.keys(prefetchedResources).forEach(resourceKey => {
+    let resourceList = [];
+    if (Array.isArray(prefetchedResources[resourceKey])) {
+      resourceList = prefetchedResources[resourceKey].map(resource => {
+        return resource;
+      });
+    } else {
+      resourceList = prefetchedResources[resourceKey];
+    }
+
+    preppedResources.set(resourceKey, resourceList);
+  });
+  return preppedResources;
+};
+
+export { retrieveLaunchContext, standardsBasedGetEtasu, getMedicationSpecificRemsAdminUrl, prepPrefetch };