SurgicalCountSpineMarkerPre-ProcedureCheckTeamDebriefingProcedureSiteVerbalIdentificationSiteMarking2ndTimeOutLaterality(Side)Time-outDNRStatusSpecialWristbandConsentFormCorrectImplantRadiographicImagesPre-opVerificationUniqueIdentifierDiagnosticTestsSpecialEquipmentMedicalRecordSignedConsentPatientNameEmergencyProcedurePhysicianSignatureSurgicalCountSpineMarkerPre-ProcedureCheckTeamDebriefingProcedureSiteVerbalIdentificationSiteMarking2ndTimeOutLaterality(Side)Time-outDNRStatusSpecialWristbandConsentFormCorrectImplantRadiographicImagesPre-opVerificationUniqueIdentifierDiagnosticTestsSpecialEquipmentMedicalRecordSignedConsentPatientNameEmergencyProcedurePhysicianSignature

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