CERNERIdentityAffidavit forChildrenUnder 16FREE!CHARITYGUIDEHIPPlanSummaryDeterminationof DisabilityRMI FormConflict ofInterestFormHHWPlanSummaryFaxFormEligibilityScreeningFollow-UpWorkReleaseFormIndividualSolutionsARFTaxHouseholdSizeMartialStatusNotice of Non-DiscriminationPowerAcctFormIncomeCERNERIdentityAffidavit forChildrenUnder 16FREE!CHARITYGUIDEHIPPlanSummaryDeterminationof DisabilityRMI FormConflict ofInterestFormHHWPlanSummaryFaxFormEligibilityScreeningFollow-UpWorkReleaseFormIndividualSolutionsARFTaxHouseholdSizeMartialStatusNotice of Non-DiscriminationPowerAcctFormIncome

BINGO ELIGIBILITY - 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. CERNER
  2. Identity Affidavit for Children Under 16
  3. FREE!
  4. CHARITY GUIDE
  5. HIP Plan Summary
  6. Determination of Disability RMI Form
  7. Conflict of Interest Form
  8. HHW Plan Summary
  9. Fax Form
  10. Eligibility
  11. Screening
  12. Follow-Up
  13. Work Release Form
  14. Individual Solutions
  15. ARF
  16. Tax Household Size
  17. Martial Status
  18. Notice of Non-Discrimination
  19. Power Acct Form
  20. Income