edit-appt.php

 if($appt_day == null || $appt_time == null) {
      if($appt_referred !== null && $appt_notes !== null) {
        $update = $wpdb->update('ea_appts',
          array(
            'referral' => $appt_referred,
            'notes' => $appt_notes,
            'updated_by' => $user_id
          ), array('id' => $appt_id)
        );
      } else if($appt_referred == null) {
        $update = $wpdb->update('ea_appts',
          array(
            'notes' => $appt_notes,
            'updated_by' => $user_id
          ), array('id' => $appt_id)
        );
      } else if ($appt_notes == null) {
        $update = $wpdb->update('ea_appts',
          array(
            'referral' => $appt_referred
            'updated_by' => $user_id
          ), array('id' => $appt_id)
        );
      }
    }