ProcedureSiteDiagnosticTestsUniqueIdentifierSpecialWristbandConsentFormCorrectImplantMedicalRecordSignedConsentPre-opVerificationSpecialEquipmentRadiographicImagesPatientNamePre-ProcedureCheckSignedConsentPre-opVerificationConsentFormMedicalRecordFREESPACESpecialWristbandSpineMarkerTeamDebriefingTime-outSpineMarkerSurgicalCountLaterality(Side)DiagnosticTestsEmergencyProcedure2ndTimeOutEmergencyProcedurePhysicianSignatureTime-outDNRStatusTeamConcurrenceVerbalIdentificationTeamDebriefingLaterality(Side)SpecialEquipmentPatientNameCorrectImplantPhysicianSignatureSiteMarkingSurgicalCountUniqueIdentifierProcedureSiteSiteMarkingDNRStatusPre-ProcedureCheckVerbalIdentificationRadiographicImagesProcedureSiteDiagnosticTestsUniqueIdentifierSpecialWristbandConsentFormCorrectImplantMedicalRecordSignedConsentPre-opVerificationSpecialEquipmentRadiographicImagesPatientNamePre-ProcedureCheckSignedConsentPre-opVerificationConsentFormMedicalRecordFREESPACESpecialWristbandSpineMarkerTeamDebriefingTime-outSpineMarkerSurgicalCountLaterality(Side)DiagnosticTestsEmergencyProcedure2ndTimeOutEmergencyProcedurePhysicianSignatureTime-outDNRStatusTeamConcurrenceVerbalIdentificationTeamDebriefingLaterality(Side)SpecialEquipmentPatientNameCorrectImplantPhysicianSignatureSiteMarkingSurgicalCountUniqueIdentifierProcedureSiteSiteMarkingDNRStatusPre-ProcedureCheckVerbalIdentificationRadiographicImages

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