As of right now, there is no way of importing a letterhead into QuickBooks Online. However, you can import custom form styles and also add logos to have on invoices. Allow me to explain.
Custom form styles are the different design layouts you can use on invoices. Please see the screenshot below of an example of what a custom style form looks like.
You can turn on the Custom Import style. Go to Gear Icon and QuickBooks Labs. This will allow you to take a MS Word docx file and customize it with your letterhead and map any needed fields. For the most part, if you can customize it in MS Word, it will show in QuickBooks Online.
This is ESPECIALLY useful if sending online invoices and you want to use lots of images and color since you don't need to worry about your customers running through lots of ink printing out the invoices you send them.
Attached is an example I did for online invoices.
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