The following is a way to accomplish what you are looking for. Do note that the sections that have "int_Temp - #" may have to be adjusted based on the actual form received. What it is doing is subtracking the spaces from the end of the array which may be more or less than the actual e-mail you are getting. Just play with it to get it right. In order to get the code to work you are going to have to setup a rule to run it when an e-mail with the proper subject comes in (I am assuming that the subject is autopopulated for the form).
Code:
Public Sub AutoReply(oMailItem As Outlook.MailItem)
Dim oMail As Outlook.MailItem
Dim str_FirstName
Dim str_LastName
Dim str_Email As String
Dim str_Date
Dim str_Time
Dim arr
Dim int_Temp As Integer
Dim str_Body As String
On Error Resume Next
arr = Split(oMailItem.Body, ":")
int_Temp = Len(arr(6))
str_FirstName = Mid(arr(6), 2, int_Temp - 13)
int_Temp = Len(arr(7))
str_LastName = Mid(arr(7), 2, int_Temp - 16)
int_Temp = Len(arr(8))
str_Email = Mid(arr(8), 2, int_Temp - 17)
int_Temp = Len(arr(9))
str_Date = Mid(arr(9), 2, int_Temp - 25)
int_Temp = Len(arr(12))
str_Time = arr(10) & ":" & arr(11) & ":" & Mid(arr(12), 1, int_Temp - 10)
str_Body = "Thank you " & str_FirstName & " " & str_LastName & " for your request for an appointment on " & str_Date & " at" & str_Time & " ... yadda yadda, blah blah."
'Create a new mail item
Set oMail = Application.CreateItem(olMailItem)
'Set the proper fields of the e-mail and send it
With oMail
.To = oMailItem.SenderEmailAddress
.Subject = " " & oMailItem.Subject
.Body = str_Body
'.Display
.Send
End With
End Sub