diff --git a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/hie-resource.ts b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/hie-resource.ts
index 2f92c7073..de359feaa 100644
--- a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/hie-resource.ts
+++ b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/hie-resource.ts
@@ -3,6 +3,8 @@ import { type PatientIdentifierValue, type FormValues } from '../../patient-regi
 import { type MapperConfig, type HIEPatient, type ErrorResponse } from './hie-types';
 import { openmrsFetch, restBaseUrl } from '@openmrs/esm-framework';
 import { v4 } from 'uuid';
+import { z } from 'zod';
+import dayjs from 'dayjs';
 /**
  * Represents a client for interacting with a Health Information Exchange (HIE) resource.
  * @template T - The type of the resource being fetched.
@@ -182,3 +184,79 @@ export const getPatientName = (patient: fhir.Patient) => {
   const middleName = patient.name[0]?.['given']?.[0]?.replace(givenName, '')?.trim() ?? '';
   return { familyName, givenName, middleName };
 };
+
+export const authorizationFormSchema = z.object({
+  otp: z.string().min(1, 'Required'),
+  receiver: z
+    .string()
+    .regex(/^(\+?254|0)((7|1)\d{8})$/)
+    .optional(),
+});
+
+export function generateOTP(length = 5) {
+  let otpNumbers = '0123456789';
+  let OTP = '';
+  const len = otpNumbers.length;
+  for (let i = 0; i < length; i++) {
+    OTP += otpNumbers[Math.floor(Math.random() * len)];
+  }
+  return OTP;
+}
+
+export function persistOTP(otp: string, patientUuid: string) {
+  sessionStorage.setItem(
+    patientUuid,
+    JSON.stringify({
+      otp,
+      timestamp: new Date().toISOString(),
+    }),
+  );
+}
+
+export async function sendOtp({ otp, receiver }: z.infer<typeof authorizationFormSchema>, patientName: string) {
+  const payload = parseMessage(
+    { otp, patient_name: patientName, expiry_time: 5 },
+    'Dear {{patient_name}}, your OTP for accessing your Shared Health Records (SHR) is {{otp}}. Please enter this code to proceed. The code is valid for {{expiry_time}} minutes.',
+  );
+
+  const url = `${restBaseUrl}/kenyaemr/send-kenyaemr-sms?message=${payload}&phone=${receiver}`;
+
+  const res = await openmrsFetch(url, {
+    method: 'POST',
+    redirect: 'follow',
+  });
+  if (res.ok) {
+    return await res.json();
+  }
+  throw new Error('Error sending otp');
+}
+
+function parseMessage(object, template) {
+  const placeholderRegex = /{{(.*?)}}/g;
+
+  const parsedMessage = template.replace(placeholderRegex, (match, fieldName) => {
+    if (object.hasOwnProperty(fieldName)) {
+      return object[fieldName];
+    } else {
+      return match;
+    }
+  });
+
+  return parsedMessage;
+}
+export function verifyOtp(otp: string, patientUuid: string) {
+  const data = sessionStorage.getItem(patientUuid);
+  if (!data) {
+    throw new Error('Invalid OTP');
+  }
+  const { otp: storedOtp, timestamp } = JSON.parse(data);
+  const isExpired = dayjs(timestamp).add(5, 'minutes').isBefore(dayjs());
+  if (storedOtp !== otp) {
+    throw new Error('Invalid OTP');
+  }
+  if (isExpired) {
+    throw new Error('OTP Expired');
+  }
+  sessionStorage.removeItem(patientUuid);
+  return 'Verification success';
+}
diff --git a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.modal.tsx b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.modal.tsx
index 21667beb4..333d58f1b 100644
--- a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.modal.tsx
+++ b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.modal.tsx
@@ -1,13 +1,16 @@
-import React from 'react';
+import { Button, ModalBody, ModalFooter, ModalHeader } from '@carbon/react';
+import React, { useState } from 'react';
 import { useTranslation } from 'react-i18next';
-import { Button, ModalBody, ModalHeader, ModalFooter, Accordion, AccordionItem, CodeSnippet } from '@carbon/react';
-import { age, ExtensionSlot, formatDate } from '@openmrs/esm-framework';
 import { type HIEPatient } from '../hie-types';
-import capitalize from 'lodash-es/capitalize';
 import styles from './confirm-hie.scss';
-import PatientInfo from '../patient-info/patient-info.component';
-import DependentInfo from '../dependants/dependants.component';
-import { getPatientName, maskData } from '../hie-resource';
+import { authorizationFormSchema, generateOTP, getPatientName, persistOTP, sendOtp, verifyOtp } from '../hie-resource';
+import HIEPatientDetailPreview from './hie-patient-detail-preview.component';
+import HIEOTPVerficationForm from './hie-otp-verification-form.component';
+import { Form } from '@carbon/react';
+import { FormProvider, useForm } from 'react-hook-form';
+import { type z } from 'zod';
+import { zodResolver } from '@hookform/resolvers/zod';
+import { showSnackbar } from '@openmrs/esm-framework';
 
 interface HIEConfirmationModalProps {
   closeModal: () => void;
@@ -17,77 +20,78 @@ interface HIEConfirmationModalProps {
 
 const HIEConfirmationModal: React.FC<HIEConfirmationModalProps> = ({ closeModal, patient, onUseValues }) => {
   const { t } = useTranslation();
-  const { familyName, givenName, middleName } = getPatientName(patient);
+  const [mode, setMode] = useState<'authorization' | 'preview'>('preview');
+  const [status, setStatus] = useState<'loadingOtp' | 'otpSendSuccessfull' | 'otpFetchError'>();
+  const phoneNumber = patient?.telecom?.find((num) => num.value)?.value;
+  const getidentifier = (code: string) =>
+    patient?.identifier?.find((identifier) => identifier?.type?.coding?.some((coding) => coding?.code === code));
+  const patientId = patient?.id ?? getidentifier('SHA-number')?.value;
+  const form = useForm<z.infer<typeof authorizationFormSchema>>({
+    defaultValues: {
+      receiver: phoneNumber,
+    },
+    resolver: zodResolver(authorizationFormSchema),
+  });
+  const patientName = getPatientName(patient);
 
-  const handleUseValues = () => {
-    onUseValues();
-    closeModal();
+  const onSubmit = async (values: z.infer<typeof authorizationFormSchema>) => {
+    try {
+      verifyOtp(values.otp, patientId);
+      showSnackbar({ title: 'Success', kind: 'success', subtitle: 'Access granted successfully' });
+      onUseValues();
+      closeModal();
+    } catch (error) {
+      showSnackbar({ title: 'Faulure', kind: 'error', subtitle: `${error}` });
+    }
   };
 
   return (
-    <div>
-      <ModalHeader closeModal={closeModal}>
-        <span className={styles.header}>{t('hieModal', 'HIE Patient Record Found')}</span>
-      </ModalHeader>
-      <ModalBody>
-        <div className={styles.patientDetails}>
-          <ExtensionSlot
-            className={styles.patientPhotoContainer}
-            name="patient-photo-slot"
-            state={{ patientName: `${maskData(givenName)} . ${maskData(middleName)} . ${maskData(familyName)}` }}
-          />
-          <div className={styles.patientInfoContainer}>
-            <PatientInfo label={t('healthID', 'HealthID')} value={patient?.id} />
-            <PatientInfo
-              label={t('patientName', 'Patient name')}
-              customValue={
-                <span className={styles.patientNameValue}>
-                  <p>{maskData(givenName)}</p>
-                  <span>&bull;</span>
-                  <p>{maskData(middleName)}</p>
-                  <span>&bull;</span>
-                  <p>{maskData(familyName)}</p>
-                </span>
-              }
+    <FormProvider {...form}>
+      <Form onSubmit={form.handleSubmit(onSubmit)}>
+        <ModalHeader closeModal={closeModal}>
+          <span className={styles.header}>
+            {mode === 'authorization'
+              ? t('hiePatientVerification', 'HIE Patient Verification')
+              : t('hieModal', 'HIE Patient Record Found')}
+          </span>
+        </ModalHeader>
+        <ModalBody>
+          {mode === 'authorization' ? (
+            <HIEOTPVerficationForm
+              name={`${patientName.givenName} ${patientName.middleName}`}
+              patientId={patientId}
+              status={status}
+              setStatus={setStatus}
             />
+          ) : (
+            <HIEPatientDetailPreview patient={patient} />
+          )}
+        </ModalBody>
+        <ModalFooter>
+          <Button kind="secondary" onClick={closeModal}>
+            {t('cancel', 'Cancel')}
+          </Button>
 
-            <PatientInfo label={t('age', 'Age')} value={age(patient?.birthDate)} />
-            <PatientInfo label={t('dateOfBirth', 'Date of birth')} value={formatDate(new Date(patient?.birthDate))} />
-            <PatientInfo label={t('gender', 'Gender')} value={capitalize(patient?.gender)} />
-            <PatientInfo
-              label={t('maritalStatus', 'Marital status')}
-              value={patient?.maritalStatus?.coding?.map((m) => m.code).join('')}
-            />
-
-            {(!patient?.contact || patient?.contact.length === 0) && (
-              <PatientInfo label={t('dependents', 'Dependents')} value="--" />
-            )}
-          </div>
-        </div>
-
-        <DependentInfo dependents={patient?.contact} />
-
-        <div>
-          <Accordion>
-            <AccordionItem title={t('viewFullResponse', 'View full response')}>
-              <CodeSnippet type="multi" feedback="Copied to clipboard">
-                {JSON.stringify(patient, null, 2)}
-              </CodeSnippet>
-            </AccordionItem>
-          </Accordion>
-        </div>
-      </ModalBody>
-      <ModalFooter>
-        <Button kind="secondary" onClick={closeModal}>
-          {t('cancel', 'Cancel')}
-        </Button>
-
-        <Button onClick={handleUseValues} kind="primary">
-          {t('useValues', 'Use values')}
-        </Button>
-      </ModalFooter>
-    </div>
+          {mode === 'preview' && (
+            <Button onClick={() => setMode('authorization')} kind="primary">
+              {t('useValues', 'Use values')}
+            </Button>
+          )}
+          {mode === 'authorization' && (
+            <Button
+              kind="primary"
+              type="submit"
+              disabled={form.formState.isSubmitting || status !== 'otpSendSuccessfull'}>
+              {t('verifyAndUseValues', 'Verify & Use values')}
+            </Button>
+          )}
+        </ModalFooter>
+      </Form>
+    </FormProvider>
   );
 };
 
 export default HIEConfirmationModal;
+function onVerificationSuccesfull() {
+  throw new Error('Function not implemented.');
+}
diff --git a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.scss b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.scss
index dbbda7cf1..2edad7cac 100644
--- a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.scss
+++ b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/confirm-hie.scss
@@ -48,3 +48,15 @@
     color: colors.$gray-40;
   }
 }
+
+.grid {
+  margin: 0 layout.$spacing-05;
+  padding: layout.$spacing-05 0rem 0rem orem;
+}
+
+.otpInputRow {
+  display: flex;
+  flex-direction: row;
+  gap: layout.$spacing-03;
+  align-items: flex-end;
+}
diff --git a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/hie-otp-verification-form.component.tsx b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/hie-otp-verification-form.component.tsx
new file mode 100644
index 000000000..3e16dbcaf
--- /dev/null
+++ b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/hie-otp-verification-form.component.tsx
@@ -0,0 +1,88 @@
+import { Button, Column, Row, Stack, Tag, TextInput, InlineLoading } from '@carbon/react';
+import { showSnackbar } from '@openmrs/esm-framework';
+import React from 'react';
+import { Controller, useFormContext } from 'react-hook-form';
+import { useTranslation } from 'react-i18next';
+import { type authorizationFormSchema, generateOTP, persistOTP, sendOtp } from '../hie-resource';
+import styles from './confirm-hie.scss';
+import { type z } from 'zod';
+
+type HIEOTPVerficationFormProps = {
+  name: string;
+  patientId: string;
+  status?: 'loadingOtp' | 'otpSendSuccessfull' | 'otpFetchError';
+  setStatus: React.Dispatch<React.SetStateAction<'loadingOtp' | 'otpSendSuccessfull' | 'otpFetchError'>>;
+};
+
+const HIEOTPVerficationForm: React.FC<HIEOTPVerficationFormProps> = ({ name, patientId, setStatus, status }) => {
+  const form = useFormContext<z.infer<typeof authorizationFormSchema>>();
+  const { t } = useTranslation();
+
+  const handleGetOTP = async () => {
+    try {
+      setStatus('loadingOtp');
+      const otp = generateOTP(5);
+      await sendOtp({ otp, receiver: form.watch('receiver') }, name);
+      setStatus('otpSendSuccessfull');
+      persistOTP(otp, patientId);
+    } catch (error) {
+      setStatus('otpFetchError');
+      showSnackbar({ title: t('error', 'Error'), kind: 'error', subtitle: error?.message });
+    }
+  };
+
+  return (
+    <Stack gap={4} className={styles.grid}>
+      <Column>
+        <Controller
+          control={form.control}
+          name="receiver"
+          render={({ field }) => (
+            <TextInput
+              invalid={form.formState.errors[field.name]?.message}
+              invalidText={form.formState.errors[field.name]?.message}
+              {...field}
+              placeholder={t('patientPhoneNUmber', 'Patient Phone number')}
+              labelText={t('patientPhoneNUmber', 'Patient Phone number')}
+              helperText={t('phoneNumberHelper', 'Patient will receive OTP on this number')}
+            />
+          )}
+        />
+      </Column>
+
+      <Column>
+        <Controller
+          control={form.control}
+          name="otp"
+          render={({ field }) => (
+            <Row className={styles.otpInputRow}>
+              <TextInput
+                invalid={form.formState.errors[field.name]?.message}
+                invalidText={form.formState.errors[field.name]?.message}
+                {...field}
+                placeholder={t('otpCode', 'OTP Authorization code')}
+                labelText={t('otpCode', 'OTP Authorization code')}
+              />
+              <Button
+                onClick={handleGetOTP}
+                role="button"
+                type="blue"
+                kind="tertiary"
+                disabled={['loadingOtp', 'otpSendSuccessfull'].includes(status)}>
+                {status === 'loadingOtp' ? (
+                  <InlineLoading status="active" iconDescription="Loading" description="Loading data..." />
+                ) : status === 'otpFetchError' ? (
+                  t('retry', 'Retry')
+                ) : (
+                  t('verifyOTP', 'Verify with OTP')
+                )}
+              </Button>
+            </Row>
+          )}
+        />
+      </Column>
+    </Stack>
+  );
+};
+
+export default HIEOTPVerficationForm;
diff --git a/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/hie-patient-detail-preview.component.tsx b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/hie-patient-detail-preview.component.tsx
new file mode 100644
index 000000000..320506fa1
--- /dev/null
+++ b/packages/esm-patient-registration-app/src/client-registry/hie-client-registry/modal/hie-patient-detail-preview.component.tsx
@@ -0,0 +1,73 @@
+import { Accordion, AccordionItem, CodeSnippet } from '@carbon/react';
+import { age, ExtensionSlot, formatDate } from '@openmrs/esm-framework';
+import capitalize from 'lodash-es/capitalize';
+import React from 'react';
+import { useTranslation } from 'react-i18next';
+import DependentInfo from '../dependants/dependants.component';
+import { getPatientName, maskData } from '../hie-resource';
+import PatientInfo from '../patient-info/patient-info.component';
+import styles from './confirm-hie.scss';
+
+type HIEPatientDetailPreviewProps = {
+  patient: fhir.Patient;
+};
+
+const HIEPatientDetailPreview: React.FC<HIEPatientDetailPreviewProps> = ({ patient }) => {
+  const { familyName, givenName, middleName } = getPatientName(patient);
+  const { t } = useTranslation();
+  const getidentifier = (code: string) =>
+    patient?.identifier?.find((identifier) => identifier?.type?.coding?.some((coding) => coding?.code === code));
+
+  return (
+    <>
+      <div className={styles.patientDetails}>
+        <ExtensionSlot
+          className={styles.patientPhotoContainer}
+          name="patient-photo-slot"
+          state={{ patientName: `${maskData(givenName)} . ${maskData(middleName)} . ${maskData(familyName)}` }}
+        />
+        <div className={styles.patientInfoContainer}>
+          <PatientInfo label={t('healthID', 'HealthID')} value={getidentifier('SHA-number')?.value} />
+          <PatientInfo
+            label={t('patientName', 'Patient name')}
+            customValue={
+              <span className={styles.patientNameValue}>
+                <p>{maskData(givenName)}</p>
+                <span>&bull;</span>
+                <p>{maskData(middleName)}</p>
+                <span>&bull;</span>
+                <p>{maskData(familyName)}</p>
+              </span>
+            }
+          />
+
+          <PatientInfo label={t('age', 'Age')} value={age(patient?.birthDate)} />
+          <PatientInfo label={t('dateOfBirth', 'Date of birth')} value={formatDate(new Date(patient?.birthDate))} />
+          <PatientInfo label={t('gender', 'Gender')} value={capitalize(patient?.gender)} />
+          <PatientInfo
+            label={t('maritalStatus', 'Marital status')}
+            value={patient?.maritalStatus?.coding?.map((m) => m.code).join('')}
+          />
+
+          {(!patient?.contact || patient?.contact.length === 0) && (
+            <PatientInfo label={t('dependents', 'Dependents')} value="--" />
+          )}
+        </div>
+      </div>
+
+      <DependentInfo dependents={patient?.contact} />
+
+      <div>
+        <Accordion>
+          <AccordionItem title={t('viewFullResponse', 'View full response')}>
+            <CodeSnippet type="multi" feedback="Copied to clipboard">
+              {JSON.stringify(patient, null, 2)}
+            </CodeSnippet>
+          </AccordionItem>
+        </Accordion>
+      </div>
+    </>
+  );
+};
+
+export default HIEPatientDetailPreview;
diff --git a/packages/esm-patient-registration-app/translations/en.json b/packages/esm-patient-registration-app/translations/en.json
index 27329b70f..da51c50a8 100644
--- a/packages/esm-patient-registration-app/translations/en.json
+++ b/packages/esm-patient-registration-app/translations/en.json
@@ -74,6 +74,7 @@
   "givenNameRequired": "Given name is required",
   "healthID": "HealthID",
   "hieModal": "HIE Patient Record Found",
+  "hiePatientVerification": "HIE Patient Verification",
   "identifierSearch": "Identifier search",
   "identifierType": "Identifier type",
   "identifierValueRequired": "Identifier value is required",
@@ -101,12 +102,15 @@
   "optional": "optional",
   "optionalIdentifierLabel": "{{identifierName}} (optional)",
   "other": "Other",
+  "otpCode": "OTP Authorization code",
   "patientDetailsFound": "Patient information found in the registry, do you want to use the information to continue with registration?",
   "patientName": "Patient name",
   "patientNameKnown": "Patient's Name is Known?",
   "patientNotFound": "The patient records could not be found in Client registry, do you want to continue to create and post patient to registry",
+  "patientPhoneNUmber": "Patient Phone number",
   "patientRegistrationBreadcrumb": "Patient Registration",
   "patientVerificationFromHIE": "Patient verification from HIE",
+  "phoneNumberHelper": "Patient will receive OTP on this number",
   "postToRegistry": "Post to registry",
   "refreshOrContactAdmin": "Try refreshing the page or contact your system administrator",
   "registerPatient": "Register patient",
@@ -124,6 +128,7 @@
   "removeIdentifierButton": "Remove identifier",
   "resetIdentifierTooltip": "Reset",
   "restoreRelationshipActionButton": "Undo",
+  "retry": "Retry",
   "searchAddress": "Search address",
   "searchClientRegistry": "Search client registry",
   "searchIdentifierPlaceholder": "Search identifier",
@@ -149,6 +154,8 @@
   "updatePatientSuccessSnackbarTitle": "Patient Details Updated",
   "useValues": "Use values",
   "validate": "Validate",
+  "verifyAndUseValues": "Verify & Use values",
+  "verifyOTP": "Verify with OTP",
   "viewFullResponse": "View full response",
   "yearsEstimateRequired": "Estimated years required",
   "yes": "Yes"