UsedprognosisstatementObservedpeerusing SICguideExplainedSIC convto staffnursePresentedSIC/ACPinfo at teammeetingReceivedthanks frommember orfamily forSIC convUsed ethicscommitteefor ethicaldilemmaUsed SICguide withmember'sson or dtrUsedANDinstead ofDNRUsed SICguide withmemberUsed SICguide withspouseUsed SICguide forCOVIDMade recbase onSIC convUsed SICguideover thephoneUsed peerreviewfeedbackformUsed"Some/Other"techniqueDiscusseddecisionalcapacitywith PCPRespondedto emotionOrderedpsych consultto determinedecisioncapacityNew clinicianobservedyou usingSICExplainedadvancedirectivesto memberTransferredmember toHS due toSIC convExplainedSIC convto MSWExplainedSIC convto PCPUsed "Iwish butI worry" UsedprognosisstatementObservedpeerusing SICguideExplainedSIC convto staffnursePresentedSIC/ACPinfo at teammeetingReceivedthanks frommember orfamily forSIC convUsed ethicscommitteefor ethicaldilemmaUsed SICguide withmember'sson or dtrUsedANDinstead ofDNRUsed SICguide withmemberUsed SICguide withspouseUsed SICguide forCOVIDMade recbase onSIC convUsed SICguideover thephoneUsed peerreviewfeedbackformUsed"Some/Other"techniqueDiscusseddecisionalcapacitywith PCPRespondedto emotionOrderedpsych consultto determinedecisioncapacityNew clinicianobservedyou usingSICExplainedadvancedirectivesto memberTransferredmember toHS due toSIC convExplainedSIC convto MSWExplainedSIC convto PCPUsed "Iwish butI worry" 

CCM SIC 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. Used prognosis statement
  2. Observed peer using SIC guide
  3. Explained SIC conv to staff nurse
  4. Presented SIC/ACP info at team meeting
  5. Received thanks from member or family for SIC conv
  6. Used ethics committee for ethical dilemma
  7. Used SIC guide with member's son or dtr
  8. Used AND instead of DNR
  9. Used SIC guide with member
  10. Used SIC guide with spouse
  11. Used SIC guide for COVID
  12. Made rec base on SIC conv
  13. Used SIC guide over the phone
  14. Used peer review feedback form
  15. Used "Some/Other" technique
  16. Discussed decisional capacity with PCP
  17. Responded to emotion
  18. Ordered psych consult to determine decision capacity
  19. New clinician observed you using SIC
  20. Explained advance directives to member
  21. Transferred member to HS due to SIC conv
  22. Explained SIC conv to MSW
  23. Explained SIC conv to PCP
  24. Used "I wish but I worry"