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This paper presents a system that will support a remote guidance collaboration, in which a local expert guides a remotely located assistant to perform physical, three-dimensional tasks. The system supports this remote guidance by allowing the expert to annotate, point at and draw upon objects in the remote location using a pen and tablet-based interface to control a laser projection device. The specific design criteria for this system are drawn from a tele-health scenario involving remote medical examination of patients and the paper presents the software architecture and implementation details of the associated hardware. In particular, the algorithm for aligning the representation of the laser projection over the video display of the remote scene is described. Early evaluations by medical specialists are presented, the usability of the system in laboratory experiments is discussed and ideas for future developments are outlined.