MedicalRecordPre-opVerificationSpineMarkerSurgicalCountDiagnosticTestsConsentFormRadiographicImagesTime-outSpecialEquipmentDNRStatusSignedConsentPre-ProcedureCheckUniqueIdentifierSiteMarkingLaterality(Side)TeamDebriefingSpecialWristbandVerbalIdentification2ndTimeOutEmergencyProcedurePatientNameProcedureSiteCorrectImplantPhysicianSignatureMedicalRecordPre-opVerificationSpineMarkerSurgicalCountDiagnosticTestsConsentFormRadiographicImagesTime-outSpecialEquipmentDNRStatusSignedConsentPre-ProcedureCheckUniqueIdentifierSiteMarkingLaterality(Side)TeamDebriefingSpecialWristbandVerbalIdentification2ndTimeOutEmergencyProcedurePatientNameProcedureSiteCorrectImplantPhysicianSignature

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