The Instinctive Notes App is designed to work offline.
If Instinctive Notes is unavailable you can continue taking notes and these will be stored on your device and sent to Instinctive Notes when the service is available again.
Similarly, if your practice management system is unavailable for any reason you can continue taking notes without impact.
If there is an extended period without service then your Appointments list will become out of date. You can continue to taking clinical notes for your patients even if there is no appointment.
You can safely work offline knowing that everything you record will be synced up to the cloud when it's available again.