SpineMarkerCorrectImplantConsentFormConsentFormPre-opVerificationTeamDebriefingLaterality(Side)PatientNameMedicalRecordPatientNamePre-ProcedureCheckSignedConsentEmergencyProcedureSiteMarkingUniqueIdentifierTime-outSpecialWristbandPre-ProcedureCheckMedicalRecordCorrectImplantDiagnosticTestsRadiographicImagesProcedureSiteVerbalIdentificationVerbalIdentificationSpecialEquipmentRadiographicImagesTime-outSignedConsentPhysicianSignatureUniqueIdentifierPre-opVerification2ndTimeOutDNRStatusFREESPACEPhysicianSignatureSpineMarkerSpecialWristbandSiteMarkingDiagnosticTestsTeamDebriefingSurgicalCountEmergencyProcedureDNRStatusTeamConcurrenceSurgicalCountLaterality(Side)ProcedureSiteSpecialEquipmentSpineMarkerCorrectImplantConsentFormConsentFormPre-opVerificationTeamDebriefingLaterality(Side)PatientNameMedicalRecordPatientNamePre-ProcedureCheckSignedConsentEmergencyProcedureSiteMarkingUniqueIdentifierTime-outSpecialWristbandPre-ProcedureCheckMedicalRecordCorrectImplantDiagnosticTestsRadiographicImagesProcedureSiteVerbalIdentificationVerbalIdentificationSpecialEquipmentRadiographicImagesTime-outSignedConsentPhysicianSignatureUniqueIdentifierPre-opVerification2ndTimeOutDNRStatusFREESPACEPhysicianSignatureSpineMarkerSpecialWristbandSiteMarkingDiagnosticTestsTeamDebriefingSurgicalCountEmergencyProcedureDNRStatusTeamConcurrenceSurgicalCountLaterality(Side)ProcedureSiteSpecialEquipment

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