Checkboxes in the [app_confirmation] area

Hi

I installed your Appointments Plugin and figured all out but i is it possible to insert checkboxes the client has to fill out in order to make an appointment? I need this plugin for an service where i need to know some additional information upfront... i tried to use the shortcode [app_confirmation ... note="Your notes:"] but that doesnt work... i mean it doesnt work at all... nothing shows up in the front end... and i also need checkboxes?

thx 4 help