Leslie,
I know I keep repeating this, but I am not sure what post you are reading.
Would it work for you if before you send the note to your front desk, if you hit CTRL - S. It will be in your Inbox instantly. Then open it and send it, and you will have a backup copy.
When we used Medisoft, you could enter the next appointment and then print it, but kind of like our prescriptions, it would print on an 8 1/2 by 11 sheet of paper. But, like our scripts and labs, etc. it was nice to know the patient had the EXACT replica of what we had. How many of us at least once monthly have a patient show up with a card that says that exact time slot, but we don't have him or her down. You have to honor their appt card.