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<?php 
  $options = array(
    'html' => TRUE,
    'title' => t('SOME TITLE'),
    'attributes' => array('class' => array('button color medium'))
  );

  $output['content'] = l(t('Schedule an appointment'), 'node/8', $options);
?>

<?php print l('<span>' . t('MY TITLE') . '</span>', 'myurl', array('html' => TRUE, 'title' => t('SOME TITLE'), 'attributes' => array('class' => 'myclass'))); ?>