(919) 813-7290 | (919) 729-5343

markharol@gmail.com | dianemyerslpc@gmail.com

Mind over Mood Wellness Center

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Client Forms

If you are new to therapy or counseling, please be sure to fill out the following forms, and bring them to your first session. This will help ease you into therapy and allow as much time as possible to focus on you.

Mark Harol’s Client Intake Form

Diane Myers’ Client Intake Form

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Mark Harol, MS, LPC, NCC

(919) 813-7290
markharol@gmail.com

Diane Myers, MA, LPCA

(919) 729-5343
dianemyerslpc@gmail.com

310 Raleigh St
Holly Springs, NC 27540

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Contact Information

310 Raleigh St
Holly Springs, NC 27540

Mark Harol, MS, LPC, NCC
(919) 813-7290
markharol@gmail.com

Diane Myers, MA, LPCA
(919) 729-5343
dianemyerslpc@gmail.com

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