I'm sure this has been talked about a thousand times, but after a quick search of the Polycount forums I didn't find the solution. The problem is Windows 7 has all kinds of built in pen and tablet settings and pings and popups that really make a professional tablet useless. I've just set up a new machine with Windows 7 and an Intuos 4 so it's nice and fresh in my mind. Here is the solution:
Windows Features > Disable Tablet PC Components
Pen and Touch > Flicks > OFF
Pen and Touch > Use the pen button as right-click equivalent > ON
Pen and Touch > Use the top of the pen to erase ink > OFF (might not matter)
Pen and Touch > Press and Hold Settings > OFF
Pen and Touch > Input Panel Gesture Settings > OFF
Run gpedit from command line (not from Run in Start menu).
Navigate to User Configuration - Administrative Templates - Windows Components - Tablet PC - Cursor.
Enable the Turn off pen feedback setting.