VerbalIdentificationSurgicalCountEmergencyProcedureDNRStatusUniqueIdentifierPre-ProcedureCheckMedicalRecordConsentFormTime-outPatientNameCorrectImplantPhysicianSignatureSiteMarkingProcedureSitePre-opVerificationTeamDebriefingDiagnosticTestsRadiographicImagesSignedConsentSpecialEquipmentSpineMarkerSpecialWristbandLaterality(Side)2ndTimeOutVerbalIdentificationSurgicalCountEmergencyProcedureDNRStatusUniqueIdentifierPre-ProcedureCheckMedicalRecordConsentFormTime-outPatientNameCorrectImplantPhysicianSignatureSiteMarkingProcedureSitePre-opVerificationTeamDebriefingDiagnosticTestsRadiographicImagesSignedConsentSpecialEquipmentSpineMarkerSpecialWristbandLaterality(Side)2ndTimeOut

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