ElectronicSignaturePatientSignatureDateMissingPatientDirectiveHIV/AIDSClauseMissingPoA orPersonalRepPurposeofDisclosureMissingPatientIdentifierMismatchInformationto beDisclosedMissingAuthNeededbut notProvidedPatientSignatureMissingSignatureDate inthe FutureWho isReleasingMissingAuth isPoorQualityMissingLetterof RepSensitiveInformationMissingAuth inAnotherLanguageRequestedInfo differsfromAuthorizedInfoRequestorAddressdoes notmatchRequestRe-DisclosureStatementMissingRevocationStatementMissingExpirationDate/EventMissingConditioningStatementMissingWho isReceivingMissingAuth DOESNOT allowSensitiveInfoElectronicSignaturePatientSignatureDateMissingPatientDirectiveHIV/AIDSClauseMissingPoA orPersonalRepPurposeofDisclosureMissingPatientIdentifierMismatchInformationto beDisclosedMissingAuthNeededbut notProvidedPatientSignatureMissingSignatureDate inthe FutureWho isReleasingMissingAuth isPoorQualityMissingLetterof RepSensitiveInformationMissingAuth inAnotherLanguageRequestedInfo differsfromAuthorizedInfoRequestorAddressdoes notmatchRequestRe-DisclosureStatementMissingRevocationStatementMissingExpirationDate/EventMissingConditioningStatementMissingWho isReceivingMissingAuth DOESNOT allowSensitiveInfo

Authorization Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Electronic Signature
  2. Patient Signature Date Missing
  3. Patient Directive
  4. HIV/AIDS Clause Missing
  5. PoA or Personal Rep
  6. Purpose of Disclosure Missing
  7. Patient Identifier Mismatch
  8. Information to be Disclosed Missing
  9. Auth Needed but not Provided
  10. Patient Signature Missing
  11. Signature Date in the Future
  12. Who is Releasing Missing
  13. Auth is Poor Quality
  14. Missing Letter of Rep
  15. Sensitive Information Missing
  16. Auth in Another Language
  17. Requested Info differs from Authorized Info
  18. Requestor Address does not match Request
  19. Re-Disclosure Statement Missing
  20. Revocation Statement Missing
  21. Expiration Date/Event Missing
  22. Conditioning Statement Missing
  23. Who is Receiving Missing
  24. Auth DOES NOT allow Sensitive Info