Upper GIaddendummissingMedicalDisclosurePanel boxinitialsPt AOx4but familysignedconsentDementia inmedicalhistory andpt signedconsentAddendumnotwitnessedBandingrisk notinitialedPEGrisk notinitialeddatemissingabbreviatedprocedurephysiciannameincompleteAlzheimer'sin medicalhistory andpt signedconsentBronchoscopyriskbloodadministrationmissinginitialsLungbiopsyriskERCPrisk notinitialedFluoroscopyriskBloodAdministrationrisksbloodrecirculationmissinginitialsLower GIaddendummissingpatientsignaturemissingwitnesssignaturemissingPatientsignedconsent aftergivennarcoticsreason forproceduremissingtimemissingUpper GIaddendummissingMedicalDisclosurePanel boxinitialsPt AOx4but familysignedconsentDementia inmedicalhistory andpt signedconsentAddendumnotwitnessedBandingrisk notinitialedPEGrisk notinitialeddatemissingabbreviatedprocedurephysiciannameincompleteAlzheimer'sin medicalhistory andpt signedconsentBronchoscopyriskbloodadministrationmissinginitialsLungbiopsyriskERCPrisk notinitialedFluoroscopyriskBloodAdministrationrisksbloodrecirculationmissinginitialsLower GIaddendummissingpatientsignaturemissingwitnesssignaturemissingPatientsignedconsent aftergivennarcoticsreason forproceduremissingtimemissing

Consent 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.


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
  1. Upper GI addendum missing
  2. Medical Disclosure Panel box initials
  3. Pt AOx4 but family signed consent
  4. Dementia in medical history and pt signed consent
  5. Addendum not witnessed
  6. Banding risk not initialed
  7. PEG risk not initialed
  8. date missing
  9. abbreviated procedure
  10. physician name incomplete
  11. Alzheimer's in medical history and pt signed consent
  12. Bronchoscopy risk
  13. blood administration missing initials
  14. Lung biopsy risk
  15. ERCP risk not initialed
  16. Fluoroscopy risk
  17. Blood Administration risks
  18. blood recirculation missing initials
  19. Lower GI addendum missing
  20. patient signature missing
  21. witness signature missing
  22. Patient signed consent after given narcotics
  23. reason for procedure missing
  24. time missing