Pre-opVerificationSpecialWristbandPre-ProcedureCheckSurgicalCountCorrectImplantRadiographicImagesPatientName2ndTimeOutDNRStatusDiagnosticTestsLaterality(Side)SpineMarkerEmergencyProcedureVerbalIdentificationUniqueIdentifierTeamDebriefingTime-outConsentFormSignedConsentSpecialEquipmentProcedureSitePhysicianSignatureSiteMarkingMedicalRecordPre-opVerificationSpecialWristbandPre-ProcedureCheckSurgicalCountCorrectImplantRadiographicImagesPatientName2ndTimeOutDNRStatusDiagnosticTestsLaterality(Side)SpineMarkerEmergencyProcedureVerbalIdentificationUniqueIdentifierTeamDebriefingTime-outConsentFormSignedConsentSpecialEquipmentProcedureSitePhysicianSignatureSiteMarkingMedicalRecord

Informed Consent Policy - 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. Special Wristband
  3. Pre-Procedure Check
  4. Surgical Count
  5. Correct Implant
  6. Radiographic Images
  7. Patient Name
  8. 2nd Time Out
  9. DNR Status
  10. Diagnostic Tests
  11. Laterality (Side)
  12. Spine Marker
  13. Emergency Procedure
  14. Verbal Identification
  15. Unique Identifier
  16. Team Debriefing
  17. Time-out
  18. Consent Form
  19. Signed Consent
  20. Special Equipment
  21. Procedure Site
  22. Physician Signature
  23. Site Marking
  24. Medical Record