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Patients with appointments qualify for letters based on the Days in advance of scheduled date to print reminders setting in Practice Preferences > Appt Scheduling.
For example, if a patient's appointment is scheduled for 06/01/2016 and Practice Preferences is set to 10 days, the patient qualifies and is added to a letter queue on 05/22/2016. Other patients may qualify and be added to the letter queue on a daily basis. Because of this, appointment reminder letters should be monitored and printed/exported regularly.