My paper calendar is the collection bucket for appointments. It contains weekly pages for the weeks of the current month plus monthly pages for the following eleven months. When I get a new appointment or day-specific note, I put it on the paper calendar. That way it is always up to date. I update ECCO as often as I can, usually later the same day.
At the beginning of each month I print out weekly calendar pages for each week of the current month, monthly pages for months that have changes, and a new monthly page for the 12th month.
At the beginning of each week, I reprint the prior week's calendar to have a clean copy for archival purposes and then I print the upcoming week's calendar so I have a clean copy to start off with. Normally, I can just mark up the calendar pages as appointments are made, cancelled, or rescheduled. If it gets really messy, though, I will reprint it in the middle of the week.