DNRStatusSpineMarkerPre-ProcedureCheckSignedConsent2ndTimeOutSurgicalCountRadiographicImagesLaterality(Side)SpecialWristbandSpecialEquipmentDiagnosticTestsPhysicianSignatureSiteMarkingConsentFormPre-opVerificationMedicalRecordEmergencyProcedureVerbalIdentificationTeamDebriefingTime-outCorrectImplantUniqueIdentifierPatientNameProcedureSiteDNRStatusSpineMarkerPre-ProcedureCheckSignedConsent2ndTimeOutSurgicalCountRadiographicImagesLaterality(Side)SpecialWristbandSpecialEquipmentDiagnosticTestsPhysicianSignatureSiteMarkingConsentFormPre-opVerificationMedicalRecordEmergencyProcedureVerbalIdentificationTeamDebriefingTime-outCorrectImplantUniqueIdentifierPatientNameProcedureSite

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