Jobs at small Raleigh companies nobody posts about - 13 months and counting

Two small Raleigh employers told me they are hiring but have not posted yet. It has been a long 16 weeks. One is a print shop, one is an accounting firm and one is a clinic. What do you write in a cold email?

Thanks for writing this out. I went through something close to it last year, and it settled down once I kept a simple log of every call and form.