Try using the Cancel parameter to differentiate Newforma from the Send button.
Private Sub Newforma()
' Cancel = True is a flag indicating Newforma invoked Application_ItemSend
Application_ItemSend CreateItem(0), True
End Sub
Private Sub Application_ItemSend(ByVal Item As Object, Cancel As Boolean)
If Cancel = False Then ' User clicked the Send button
If MsgBox("Make sure you are sending using Newforma - Are you sure you want to send this message?", vbYesNo + vbQuestion + vbMsgBoxSetForeground, "WARNING - NEWFORMA BYPASS ?") = vbNo Then
Cancel = True
End If
Else
' Cancel starts as True when Application_ItemSend was invoked by Newforma
' Reverse the Cancel
Cancel = False
End If
End Sub