Thanks for the insight Weedpacket. I discovered the difference between \n and \r\n yesterday. My woes exist below, I don't think its a line break problem but more of a coding problem. The echo statement works fine, however, I'm not able to populate $mbody - email shows up with $mbody empty.
$programsn = tmpfile();
if (isset($HRA)) {
fwrite($programsn, "Health Risk Assessment\n"); }
// email confirmation
$to = "me@me.com";
$subject = "Hi!";
$hbody = file_get_contents('./includes/email-head.txt', true);
$fbody = file_get_contents('./includes/email-foot.txt', true);
fseek($programsn, 0);
echo fread($programsn, 1024);
$mbody = fread($programsn, 1024);
$body = $hbody . $mbody . $fbody;
mail($to, $subject, $body);
close($programsn);