MOBILE INTENSIVE CARE NURSE AUTHORIZATION & RE-AUTHORIZATION

On this page:
How Do I Become Authorized? | Application Forms & Fees | Authorization Policy | FAQs

HOW DO I BECOME AUTHORIZED?

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To be eligible for MICN authorization you must:

1. Be currently licensed as a registered nurse, in good standing, in California.
2. Have at least six (6) months experience as a full-time RN in a critical care area in the past two (2) years.
3. Successfully complete MICN course.
4. Successfully pass the San Joaquin County EMS Agency ALS Policy Examination with a minimum score of 80%.
5. Submit the required documents to the EMS Agency (see below).

Initial Authorization

1. MICN Authorization Application with Affidavit.
2. Copy of current State of California Registered Nurse License.
3. Copy of a valid state or federal ID.
4. Copy of MICN Course Completion.
5. Copy of current ACLS card.
6. Copy of current CPR, Professional Rescuer, or Health Care Provider card.
7. Copy of Course Completion for NIMS 700 or HICS equivalent.
8. Application fee (non-refundable).

Re-Authorization

1. MICN Authorization Application with Affidavit.
2. Copy of current State of California Registered Nurse License.
3. Copy of a valid state or federal ID.
4. Copy of current ACLS card.
5. Copy of current CPR, Professional Rescuer, or Health Care Provider card.
6. MICN Continuing Education Form.
7. Attendance of a Policy and Skills Review (PSR) Training and must pass the San Joaquin County Policy examination.
8. Application fee (non-refundable).

APPLICATION FORMS & FEES

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Application and Related Forms

• MICN Authorization Application (PDF)
• MICN Orientation Verification (PDF)
• MICN Continuing Education Form (PDF)
• Credit Card Authorization Form (PDF)
• Submit a Change of Address

Fees

All fees are non-refundable.

Application Fee:	$110.00 (effective July 1, 2010)
Late Fee:	$25.00 (effective July 1, 2010) for an application submitted after lapse
Rush Fee:	$25.00 (effective July 1, 2010) for an applicant that would like to have the card issued within 5 business days of a complete application being submitted
Replacement Card:	$25.00 (effective July 1, 2010)

Personal checks are no longer accepted. Acceptable payment methods are cash, Debit, Visa, MasterCard, Discover, or money order.

AUTHORIZATION POLICY

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View the MICN Authorization Policy >>

POLICY AND SKILLS REVIEW (PSR) SCHEDULE AND REGISTRATION

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You must be pre-registered to attend. Click here to view schedule and register.

PSR Study Guide - New

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An interactive study guide is available. Click here for more information.

FREQUENTLY ASKED QUESTIONS

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Q: What are acceptable CE Hours for my MICN re-authorization?

Formal classes related to prehospital care and/or emergency nursing; participation in field care audit; up to 8 hours of observation time on a SJC ALS ambulance.

Q: How long does it take for my application to be processed?

It will take approximately 2 weeks for a completed application to be processed and a temporary card issued, however, if you elect to pay the rush fee it's guaranteed to be processed in 5 business days, this includes informing your employer that your card has been processed (on request).

Q: Can I fax in my application?

No. You may bring your application in or mail it in, but it must have original signatures.