Verified practitioner channel

Medical practitioner account.

For medical doctors and dentists currently registered with the HPCSA and in good standing. Applications are verified before account activation.

Restricted channel: Novatheris, Injevia and SYNERA are considered only through approved practitioner accounts. A prescription and any other applicable documentation may be required per order. This application is not a credit application.

A · Applicant

Medical practitioner

Enter details exactly as they appear in your professional registration.

Title *

Full names *

Surname *

ID or passport number *

Profession *

HPCSA number *

Practice / PCNS number

Speciality / field *

Mobile number *

Practitioner email *

B · Entity

Practice or legal entity

Registered legal name *

Trading name *

Entity registration number

VAT number, if applicable

Practice telephone *

Practice email *

Physical practice address *

C · Fulfilment

Courier delivery address

Customer collections are not currently offered. Give the full address at which an authorised recipient can accept courier delivery.

Street address / building / suite *

City / town *

Province *

Postal code *

Authorised recipient *

Recipient mobile *

Courier access notes

D · Authority

Authorised ordering contact

This may be the applicant or a staff member formally authorised to place and coordinate orders.

Full name *

Position / role *

Mobile number *

Email address *

E · Documents

Supporting documents

PDF, JPG or PNG only. Maximum 4 MB per file and 10 MB in total. Files are emailed with this application and are not retained by the website.

ID or passport copy *

Current HPCSA proof *

Proof of practice address *Not older than 3 months.

Entity registration documents

Letter authorising ordering contactRequired only when the ordering contact is not the applicant or an authorised director/member.

F · Declaration

Verification, account terms and consent

I confirm that I am a medical doctor or dentist registered with the HPCSA, currently in good standing, and I authorise Veridia to verify my professional registration. * I understand that practitioner supply is Cash on Delivery only unless Veridia expressly agrees otherwise in writing, and that this is not a credit application. * I accept responsibility for lawful procurement, prescribing where applicable, storage, professional use, informed consent, monitoring, recordkeeping and regulatory duties relating to products ordered. * I have read and accept the full Account Terms, Disclaimer and Indemnity (July 2026). * I consent to Veridia processing the application information and supporting documents for account verification, administration, fraud prevention, regulatory recordkeeping, order fulfilment and necessary business communication, as set out in the privacy notice. * Optional: I give consent to receive Veridia portfolio, training and professional marketing updates by email. I may withdraw this consent at any time. Optional: I give consent to receive Veridia portfolio, training and professional marketing updates by WhatsApp. I may withdraw this consent at any time.

Applicant's full name *Typing your name records your electronic declaration.

Declaration date *

Submitting an application does not guarantee approval or supply. Veridia may request further documentation.