FY18 2017-2018 EMS Needs Assessment 14% of survey complete. This survey is to assist in the RAC budget, planning, and regional priorities. This form replaces our Needs Assessment Form of previous years. THE DEADLINE is May 30th, 2017 for submission!Please at the end of the survey provide any unlisted equipment and/or training. Question Title * 1. Your Contact Information Your Name: EMS Provider: Address: City: Zip Code: Email: Office Number: Cell Number: TAX ID / EIN Number: Next