ISP Review - 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.

1. Current Living Arrangmnt
2. Participant Signature
3. Start/End Dates
4. Participant Informed Rights & Choice
5. Outlier Rate
6. Authorized Units of Service & Frequency
7. Service Provider Contact Info
8. Plan Review/ Update Verific.
9. Total Waiver Cost/Day
10. Care Level
11. Current ISP Completion Date
12. Functional Screen Date
13. Initial ISP Dvlpmnt Date
14. Service Code Number
15. Outcome Number
16. Daily Cost
17. Date Signed
18. Parental Payment
19. Medicaid Cost Share
20. Name Parent(s) or Guardian
21. Funding Source
22. Plan Type
23. Unit Cost
24. Service Name