Introduction: Community paramedicine programs have existed since the early 2000s, and while resource optimization remains a predominant driver, innovation in recent years demonstrates that when community paramedicine is integrated into healthcare, it is well-positioned to support the needs of structurally marginalized communities by focusing services for those facing barriers to accessing equitable care. A recent scoping review described the evolving ways community paramedicine models are addressing health and social needs within communities around the world.Aims: We aimed to identify and explore existing community needs assessment tools, in Canada, to guide the development of a community-led and co-designed needs assessment tool for community paramedicine.Methods: We conducted a document analysis of existing community needs assessment resources to identify current tools or processes used to identify community needs, as well as determine gaps to address and support. Documents were collected for review via a targeted literature search of both published and grey sources, and direct document request of community paramedicine service providers to review guides informing current service planning, in Canada. We presented a draft of the tool to participants at a community paramedicine conference for their review and feedback and incorporated this feedback into the final version.Results: We reviewed 38 documents to identify and synthesize key elements within community health and social needs assessment tools and frameworks. Findings informed an interim Community Paramedicine Needs Assessment Tool (CPNAT) that the team presented to 112 community paramedicine experts and partners. We received 33 group responses of detailed feedback that we used to further refine and finalize the tool.Conclusions: The CPNAT will enhance health equity by guiding community paramedicine programs to better align services with the health and social care needs of communities.