SpecialWristbandRadiographicImagesSurgicalCountLaterality(Side)MedicalRecordCorrectImplantPre-ProcedureCheckTeamConcurrenceSpineMarkerEmergencyProcedureSiteMarkingPre-opVerificationUniqueIdentifierSurgicalCountSpecialEquipmentUniqueIdentifierTeamDebriefingPhysicianSignatureTime-outPatientNameDNRStatusEmergencyProcedureFREESPACEProcedureSiteDiagnosticTestsProcedureSite2ndTimeOutPatientNameTime-outSpecialWristbandDNRStatusSpineMarkerPre-ProcedureCheckVerbalIdentificationDiagnosticTestsConsentFormConsentFormSignedConsentVerbalIdentificationLaterality(Side)SignedConsentRadiographicImagesPhysicianSignatureMedicalRecordTeamDebriefingCorrectImplantPre-opVerificationSiteMarkingSpecialEquipmentSpecialWristbandRadiographicImagesSurgicalCountLaterality(Side)MedicalRecordCorrectImplantPre-ProcedureCheckTeamConcurrenceSpineMarkerEmergencyProcedureSiteMarkingPre-opVerificationUniqueIdentifierSurgicalCountSpecialEquipmentUniqueIdentifierTeamDebriefingPhysicianSignatureTime-outPatientNameDNRStatusEmergencyProcedureFREESPACEProcedureSiteDiagnosticTestsProcedureSite2ndTimeOutPatientNameTime-outSpecialWristbandDNRStatusSpineMarkerPre-ProcedureCheckVerbalIdentificationDiagnosticTestsConsentFormConsentFormSignedConsentVerbalIdentificationLaterality(Side)SignedConsentRadiographicImagesPhysicianSignatureMedicalRecordTeamDebriefingCorrectImplantPre-opVerificationSiteMarkingSpecialEquipment

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