Mobile Intensive Care Nurse Authorization & Re-Authorization

How Do I Become Authorized?

1. Be currently licensed as a registered nurse, in good standing, in California.
2. Have at least one year experience as a full-time RN in a critical care area in the past two (2) years. Prehospital liaison nurse (PLN) must verify experience by completing the verification section of the MICN application.
3. Successfully complete MICN course.
4. Submit the required documents to the SJCEMSA (see below).

1. MICN Authorization Application.
2. Copy of current State of California Registered Nurse License verification printout.
3. Copy of a valid state or federal ID.
4. Copy of MICN Course Completion certificate.
5. Copy of current ACLS card.
6. A copy (front and back) of your current CPR card for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another program approved by the SJCEMSA.
7. Current and valid Trauma Nursing Core Course (TNCC).
8. Copy of Course Completion for ICS 100/200.
9. Application fee (non-refundable).

1. MICN Authorization Application.
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. A copy (front and back) of your current CPR card for the Professional Rescuer or Healthcare Provider issued from the American Heart Association, American Red Cross, or another program approved by the SJCEMSA.
6. MICN Continuing Education Form 2610B. (Twelve (12) hours of approved EMS continuing education that shall at a minimum include completion of six (6) base hospital case reviews/field care audits held by San Joaquin General Hospital or SJCEMSA.)
7. Application fee (non-refundable).

Application Forms & Fees

• MICN Orientation Verification (PDF)
  • Online Application Portal will submit this automatically to the affiliated provider.
• MICN Continuing Education Form (PDF)

Fees
View the current fee schedule here.

All fees are non-refundable.

Authorization Policy

View the MICN Authorization Policy 

Frequently Asked Questions

Q: What are acceptable CE Hours for my MICN re-authorization?
Any EMS CE approved courses that at a minimum shall include completion of six (6) base hospital case reviews/field care audits held by San Joaquin General Hospital or SJCEMSA.

Q: How do I apply for reinstatement of my MICN Authorization after a lapse?
In order for an individual whose authorization has lapsed to be eligible for renewal, the following applies:

• For a lapse of less than twenty-four (24) months, complete renewal requirements and pay the late fee.
• For a lapse of more than twenty-four (24) months, you must complete the requirement for initial MICN Authorization.