Pre-opVerificationPre-ProcedureCheckRadiographicImagesSignedConsentSpecialWristbandSignedConsentDiagnosticTestsPatientNameSurgicalCountSpineMarkerPhysicianSignatureVerbalIdentificationLaterality(Side)RadiographicImagesSpineMarkerPhysicianSignatureTime-outPre-opVerificationTeamDebriefingMedicalRecordProcedureSiteDiagnosticTestsEmergencyProcedureSurgicalCountFREESPACECorrectImplantSiteMarkingUniqueIdentifierTeamConcurrenceSpecialEquipmentCorrectImplantPre-ProcedureCheckMedicalRecordSpecialEquipmentEmergencyProcedureTeamDebriefingDNRStatusPatientNameConsentFormTime-outUniqueIdentifierLaterality(Side)2ndTimeOutConsentFormProcedureSiteSpecialWristbandDNRStatusSiteMarkingVerbalIdentificationPre-opVerificationPre-ProcedureCheckRadiographicImagesSignedConsentSpecialWristbandSignedConsentDiagnosticTestsPatientNameSurgicalCountSpineMarkerPhysicianSignatureVerbalIdentificationLaterality(Side)RadiographicImagesSpineMarkerPhysicianSignatureTime-outPre-opVerificationTeamDebriefingMedicalRecordProcedureSiteDiagnosticTestsEmergencyProcedureSurgicalCountFREESPACECorrectImplantSiteMarkingUniqueIdentifierTeamConcurrenceSpecialEquipmentCorrectImplantPre-ProcedureCheckMedicalRecordSpecialEquipmentEmergencyProcedureTeamDebriefingDNRStatusPatientNameConsentFormTime-outUniqueIdentifierLaterality(Side)2ndTimeOutConsentFormProcedureSiteSpecialWristbandDNRStatusSiteMarkingVerbalIdentification

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