ConsentFormPatientNameMedicalRecordSpecialWristbandVerbalIdentificationSignedConsentTime-outSiteMarkingPre-opVerificationSurgicalCountProcedureSiteTime-outTeamConcurrenceSignedConsentCorrectImplantTeamDebriefingSpineMarkerSurgicalCountPre-ProcedureCheckPre-opVerificationVerbalIdentificationDiagnosticTestsEmergencyProcedureRadiographicImagesSpecialWristbandDiagnosticTestsLaterality(Side)SpecialEquipmentPre-ProcedureCheckEmergencyProcedureDNRStatusDNRStatus2ndTimeOutTeamDebriefingSpecialEquipmentFREESPACEConsentFormRadiographicImagesMedicalRecordPhysicianSignatureSpineMarkerUniqueIdentifierSiteMarkingLaterality(Side)UniqueIdentifierPatientNameProcedureSiteCorrectImplantPhysicianSignatureConsentFormPatientNameMedicalRecordSpecialWristbandVerbalIdentificationSignedConsentTime-outSiteMarkingPre-opVerificationSurgicalCountProcedureSiteTime-outTeamConcurrenceSignedConsentCorrectImplantTeamDebriefingSpineMarkerSurgicalCountPre-ProcedureCheckPre-opVerificationVerbalIdentificationDiagnosticTestsEmergencyProcedureRadiographicImagesSpecialWristbandDiagnosticTestsLaterality(Side)SpecialEquipmentPre-ProcedureCheckEmergencyProcedureDNRStatusDNRStatus2ndTimeOutTeamDebriefingSpecialEquipmentFREESPACEConsentFormRadiographicImagesMedicalRecordPhysicianSignatureSpineMarkerUniqueIdentifierSiteMarkingLaterality(Side)UniqueIdentifierPatientNameProcedureSiteCorrectImplantPhysicianSignature

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