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Dynasty Healthcare (Pty) Ltd
Reg: 2015/421262/07  |  49 Hill Street, Unit 4, Hill Park, Kroonstad, 9499
SAHPRA Section 21 Authorisation — Cannabis Prescription Request
Prescribing Healthcare Practitioner Dr B Malakoane  |  PR: 0932647  |  Chief Medical Officer
Certified Professional Medicinal Cannabis Practitioner  |  Tel: 082 560 4001  |  info@dynastyhealth.co.za
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Review process
Once submitted, your request is forwarded to Dr B Malakoane for clinical assessment. You will receive email confirmation once your prescription has been approved, or if any further information is required to complete the review.

1. Patient Details

2. Medical Information

3. Product Selection & Prescription Calculation

Enter quantity for each product. Total updates automatically. Prices in ZAR.

ProductUnitUnit PriceQtyLine Total
Consultation
Once-off practitioner consultation
once-off		 once-off R 450.00 R 0.00
Raw Cannabis Flower (Indoor)
Oral use only
per gram		 per gram R 120.00 R 0.00
Pre-Rolls (Indoor Flower)
1.2g — oral/topical use only
per unit · 1.2g		 per unit (1.2g) R 130.00 R 0.00
CannaGuard
30 capsules per bottle
30 caps / bottle		 per bottle (30 caps) R 350.00 R 0.00
CannaTea
20 teabags per box
20 bags / box		 per box (20 bags) R 270.00 R 0.00
WonderBalm
Topical application
per unit		 per unit R 380.00 R 0.00
Prescription Total (excl. VAT): R 0.00

⚠ This prescription is valid for 6 months from the date of approval.

4. Declaration & Consent

This prescription request is submitted under SAHPRA Section 21 of the Medicines and Related Substances Act, No. 101 of 1965. By submitting I confirm:

  • The information I have provided is true, correct and complete.
  • I understand raw cannabis flower products are for oral consumption only — not to be smoked, vaporised, or heated.
  • I consent to my personal and medical information being shared with Dynasty Healthcare (Pty) Ltd and the prescribing practitioner.
  • I understand this prescription is subject to approval by Dr B Malakoane and SAHPRA authorisation.
Your prescription request has been submitted. Dr Malakoane will review and you will be notified by email once approved.
Please fill in all required fields and select at least one product.

Dynasty Healthcare (Pty) Ltd · Reg 2015/421262/07 · SAHPRA Section 21 Authorised
Cannabis for Private Purposes Act No. 7 of 2024 · Medicines Act No. 101 of 1965