Laterality(Side)SpecialWristbandSignedConsentConsentFormDNRStatusPre-ProcedureCheckProcedureSiteSpineMarkerPre-ProcedureCheckDNRStatusEmergencyProcedurePre-opVerificationDiagnosticTestsTeamDebriefingSpecialWristbandTime-outCorrectImplantSpecialEquipmentUniqueIdentifierPatientNamePhysicianSignatureTeamDebriefingSignedConsentPhysicianSignatureMedicalRecordSiteMarking2ndTimeOutRadiographicImagesSurgicalCountConsentFormDiagnosticTestsFREESPACEVerbalIdentificationPre-opVerificationUniqueIdentifierLaterality(Side)TeamConcurrenceMedicalRecordSpecialEquipmentRadiographicImagesPatientNameSurgicalCountCorrectImplantVerbalIdentificationSiteMarkingTime-outProcedureSiteEmergencyProcedureSpineMarkerLaterality(Side)SpecialWristbandSignedConsentConsentFormDNRStatusPre-ProcedureCheckProcedureSiteSpineMarkerPre-ProcedureCheckDNRStatusEmergencyProcedurePre-opVerificationDiagnosticTestsTeamDebriefingSpecialWristbandTime-outCorrectImplantSpecialEquipmentUniqueIdentifierPatientNamePhysicianSignatureTeamDebriefingSignedConsentPhysicianSignatureMedicalRecordSiteMarking2ndTimeOutRadiographicImagesSurgicalCountConsentFormDiagnosticTestsFREESPACEVerbalIdentificationPre-opVerificationUniqueIdentifierLaterality(Side)TeamConcurrenceMedicalRecordSpecialEquipmentRadiographicImagesPatientNameSurgicalCountCorrectImplantVerbalIdentificationSiteMarkingTime-outProcedureSiteEmergencyProcedureSpineMarker

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