New Client Form

Click the button below to complete our secure, HIPAA compliant new client contact form. By completing this form you will be providing us with the information needed to quickly and efficiently establish services for you or your loved one.
If you would prefer to provide this information over the telephone please give us a call at (919) 617-9656 and our staff will assist you. Thank you for your interest in Mindly and we look forward to hearing from you!

Give Us a Call!
(919) 617-9656

Send Us an Email

Office Locations 

Adult Clinic
8406 Six Forks Rd
Suites 201 & 204
Raleigh, NC 27615


Child & Family Clinic
8394 Six Forks Rd
Suite 104
Raleigh, NC 27615