TeamConcurrenceTeamDebriefingEmergencyProcedureSurgicalCountEmergencyProcedureSignedConsentSpecialWristbandSpecialEquipmentPatientName2ndTimeOutSpineMarkerTeamDebriefingRadiographicImagesTime-outProcedureSiteSpecialWristbandCorrectImplantSpecialEquipmentFREESPACESiteMarkingConsentFormPhysicianSignaturePre-ProcedureCheckTime-outSurgicalCountSignedConsentDiagnosticTestsDNRStatusProcedureSiteVerbalIdentificationCorrectImplantPre-opVerificationLaterality(Side)Pre-ProcedureCheckUniqueIdentifierConsentFormDiagnosticTestsUniqueIdentifierMedicalRecordRadiographicImagesSiteMarkingSpineMarkerPhysicianSignatureMedicalRecordDNRStatusPatientNamePre-opVerificationVerbalIdentificationLaterality(Side)TeamConcurrenceTeamDebriefingEmergencyProcedureSurgicalCountEmergencyProcedureSignedConsentSpecialWristbandSpecialEquipmentPatientName2ndTimeOutSpineMarkerTeamDebriefingRadiographicImagesTime-outProcedureSiteSpecialWristbandCorrectImplantSpecialEquipmentFREESPACESiteMarkingConsentFormPhysicianSignaturePre-ProcedureCheckTime-outSurgicalCountSignedConsentDiagnosticTestsDNRStatusProcedureSiteVerbalIdentificationCorrectImplantPre-opVerificationLaterality(Side)Pre-ProcedureCheckUniqueIdentifierConsentFormDiagnosticTestsUniqueIdentifierMedicalRecordRadiographicImagesSiteMarkingSpineMarkerPhysicianSignatureMedicalRecordDNRStatusPatientNamePre-opVerificationVerbalIdentificationLaterality(Side)

Policy 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. Team Concurrence
  2. Team Debriefing
  3. Emergency Procedure
  4. Surgical Count
  5. Emergency Procedure
  6. Signed Consent
  7. Special Wristband
  8. Special Equipment
  9. Patient Name
  10. 2nd Time Out
  11. Spine Marker
  12. Team Debriefing
  13. Radiographic Images
  14. Time-out
  15. Procedure Site
  16. Special Wristband
  17. Correct Implant
  18. Special Equipment
  19. FREE SPACE
  20. Site Marking
  21. Consent Form
  22. Physician Signature
  23. Pre-Procedure Check
  24. Time-out
  25. Surgical Count
  26. Signed Consent
  27. Diagnostic Tests
  28. DNR Status
  29. Procedure Site
  30. Verbal Identification
  31. Correct Implant
  32. Pre-op Verification
  33. Laterality (Side)
  34. Pre-Procedure Check
  35. Unique Identifier
  36. Consent Form
  37. Diagnostic Tests
  38. Unique Identifier
  39. Medical Record
  40. Radiographic Images
  41. Site Marking
  42. Spine Marker
  43. Physician Signature
  44. Medical Record
  45. DNR Status
  46. Patient Name
  47. Pre-op Verification
  48. Verbal Identification
  49. Laterality (Side)