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