VerbalIdentificationSpecialEquipmentProcedureSiteConsentFormSurgicalCountSignedConsentConsentFormSpecialWristbandProcedureSiteTime-outCorrectImplantRadiographicImagesSiteMarkingDiagnosticTestsPatientNameSignedConsentDNRStatusFREESPACESpecialEquipmentCorrectImplantDNRStatusPre-opVerificationEmergencyProcedureRadiographicImagesMedicalRecordSpineMarkerVerbalIdentificationPhysicianSignaturePatientNamePhysicianSignatureUniqueIdentifierTeamDebriefingSpineMarkerSurgicalCountTime-outTeamDebriefingSpecialWristbandTeamConcurrenceEmergencyProcedureMedicalRecordLaterality(Side)SiteMarkingPre-ProcedureCheckDiagnosticTestsUniqueIdentifierPre-opVerificationLaterality(Side)Pre-ProcedureCheck2ndTimeOutVerbalIdentificationSpecialEquipmentProcedureSiteConsentFormSurgicalCountSignedConsentConsentFormSpecialWristbandProcedureSiteTime-outCorrectImplantRadiographicImagesSiteMarkingDiagnosticTestsPatientNameSignedConsentDNRStatusFREESPACESpecialEquipmentCorrectImplantDNRStatusPre-opVerificationEmergencyProcedureRadiographicImagesMedicalRecordSpineMarkerVerbalIdentificationPhysicianSignaturePatientNamePhysicianSignatureUniqueIdentifierTeamDebriefingSpineMarkerSurgicalCountTime-outTeamDebriefingSpecialWristbandTeamConcurrenceEmergencyProcedureMedicalRecordLaterality(Side)SiteMarkingPre-ProcedureCheckDiagnosticTestsUniqueIdentifierPre-opVerificationLaterality(Side)Pre-ProcedureCheck2ndTimeOut

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