Customer account
If you want to set that customers can, or need to, create a user account, you go to Settings > Settings > System Configuration > Consumer Account.
A user account makes it easier for customers to make an appointment and it gives them a appointment overview. You can indicate that customers are obliged to create a user account and possibly that only existing customers are allowed to make an appointment. Of course you can also choose this to be optional; the customer is then able to choose whether or not he creates an account.