I go to previous encounters and print all records and labs to a pdf printer (I use pdfill.com) and that makes one file of all AC notes - then I use pdfill utility to combine files and combine this file and all pdf in Imported Items / Acct number - this makes one large pdf file that I can burn to Cd or print/fax. I can do this for any pt in about 2 minutes - works great. You should download pdfill.com and give it a try.